CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Mercy Hospital Oklahoma City, Inc

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $14,556
  • Cash Discount Price: $36,734
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Mercy Hospital Oklahoma City, Inc is $14,556. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36,734. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.03x the Medicare baseline. Located in 4300 West Memorial Road, Oklahoma City, OK.
Cash / Self-Pay
$36,734

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,556

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14,116.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,116.91 (100%)
Cash / Self-Pay: $36,734 (260%)
Insurance Median: $14,556 (103%)
Cash: $36,734 (260% of Medicare)
Ins. Median: $14,556 (103% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,116.91 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Cigna $3,838 - $14,556 27%
Aetna $5,570 - $29,833 39%
Humana $7,621 - $16,462 54%
Medicaid / KanCare $7,621 - $18,923 54%
Community Care Contracted [320080] $10,936 - $21,834 77%
Workers Comp [20426] $12,214 87%
Tricare $14,006 - $14,280 99%
Blue Cross Blue Shield $14,280 - $38,779 101%
Champva [20065] $14,280 101%
Cherokee Nation Health Serv Contracted [320066] $14,280 101%
Cross Timbers Hospice [20098] $14,280 101%
Dept Of Veteran Affairs Contracted [320106] $14,280 101%
Elara Caring Aspire Hospice Contracted [320433] $14,280 101%
Elara Caring Aspire Hospice [20433] $14,280 101%
Halo Hcr Inc Hospice Contracted [320432] $14,280 101%
Halo Hcr Inc Hospice [20432] $14,280 101%
Indian Health Service Contracted [320198] $14,280 101%
Kindful Hospice Contracted [320434] $14,280 101%
Kindful Hospice [20434] $14,280 101%
Longevity Health Plan [10477] $14,280 101%
Medicare (plans) $14,280 - $15,284 101%
Mercy Hospice Okc [20252] $14,280 101%
Provider Partners Health Plans Contracted [320450] $14,280 101%
Qual Choice Contracted [320325] $14,280 101%
UnitedHealthcare $14,280 - $26,540 101%
Globalhealth Contracted [320145] $14,571 103%
Medica Contracted [320239] $14,755 105%
Amg Spec Hosp Edmond [20034] $15,284 108%
Osma Health Contracted [320292] $15,613 111%
Healthsmart Accel Contracted [320183] $17,016 121%
Healthsmart Preferred Care Contracted [320184] $17,696 - $32,130 125%
Ambetter / Centene $18,923 134%
Home State Health Plan Contracted [320187] $18,923 134%
Novasys Contracted [320285] $18,923 134%
Globalhealth Contracted [320144] $20,777 147%
Health Choice Contracted [320166] $26,290 186%
United Medical Resources Contracted [320454] $26,540 188%
Kempton Contracted [320214] $32,130 228%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4300 West Memorial Road, Oklahoma City, OK 73120
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals