CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Oklahoma Heart Hospital South, LLC

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $17,016
Cash Discount Price: $19,189
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Oklahoma Heart Hospital South, LLC is $17,016. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,189. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.21x the Medicare baseline. Located in 5200 East I-240 Service Road, Oklahoma City, OK.

Cash / Self-Pay

$19,189

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,016

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: $19,189 (136%)

Insurance Median: $17,016 (121%)

Cash: $19,189 (136% of Medicare)

Ins. Median: $17,016 (121% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Global Health	$3,517	25%
Aetna	$7,621 - $13,463	54%
Humana	$7,621 - $17,743	54%
Geha	$13,433	95%
UnitedHealthcare	$13,433 - $13,463	95%
Blue Cross Blue Shield	$13,463 - $35,023	95%
Cigna	$13,463 - $15,095	95%
Medicare (plans)	$13,463 - $13,866	95%
Va Ccn	$13,463	95%
Community Care	$16,526 - $20,194	117%
Sana Benefits	$17,016	121%
Ufcw	$17,016	121%
Ambetter / Centene	$18,848	134%
Phcs	$19,930	141%
Healthcare Highways	$22,073	156%
Healthscope	$22,886	162%
Oscar Insurance Company	$22,886	162%
The Kempton Group	$24,233	172%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $19,189.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 871.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Oklahoma Heart Hospital South, LLC is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 871.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.