CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Geisinger-Lewistown Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $25,466
Cash Discount Price: $33,222
vs. Medicare Baseline: 1.80x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Geisinger-Lewistown Hospital is $25,466. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33,222. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.80x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$33,222

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,466

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: $33,222 (235%)

Insurance Median: $25,466 (180%)

Cash: $33,222 (235% of Medicare)

Ins. Median: $25,466 (180% 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
Geisinger Health Plan	$11,852 - $16,835	84%
Medicare (plans)	$11,852	84%
Upmc Health Plan	$11,852 - $23,330	84%
Advantra	$11,971	85%
Blue Cross Blue Shield	$11,971 - $50,856	85%
Humana	$11,971	85%
Ambetter / Centene	$24,889	176%
Aetna	$26,042 - $38,290	184%
Christian Healthcare Ministries	$26,792	190%
Cigna	$28,185	200%
Christian Health Aid	$42,867	304%
Three Rivers Provider Network Inc.	$42,867	304%
Multiplan	$45,546	323%
Healthsmart Payors Organization	$48,225	342%

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 $33,222.
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 Geisinger-Lewistown Hospital 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.