CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Lancaster General Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $15,466
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Lancaster General Hospital is $15,466. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.10x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,466

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%)

Insurance Median: $15,466 (110%)

Ins. Median: $15,466 (110% 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
Workers Compensation	$7,642	54%
Gift Of Life Donor Program	$13,500	96%
Albright Life	$14,934	106%
Coatesville Va	$14,934	106%
Lebanon Veterans Hospital	$14,934	106%
UnitedHealthcare	$14,934	106%
Highmark	$14,973 - $55,190	106%
Aetna	$15,083 - $42,659	107%
Blue Cross Blue Shield	$15,158 - $49,908	107%
Amerihealth Caritas	$15,232	108%
Cigna	$15,382 - $39,155	109%
Health Partners Mcr Advantage	$15,382	109%
Medicare (plans)	$15,466 - $16,427	110%
Devoted Health	$15,680	111%
Pa Health And Wellness Mcr	$15,680	111%
Elap Employees	$21,961	156%
Oscar Health Plan	$29,120	206%
Claim Watcher Plus	$29,270	207%
Medicaid / KanCare	$30,197	214%
Claim Watcher	$32,854	233%
Highmark Commercial Preferred	$44,355	314%
Elap Other Groups	$51,037	362%
Highmark Commercial Non-Preferred	$66,923	474%

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 $X.
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 Lancaster General 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.