CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Cannon Memorial Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $11,884
Cash Discount Price: $33,908
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Cannon Memorial Hospital is $11,884. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33,908. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.84x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.

Cash / Self-Pay

$33,908

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,884

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: $33,908 (240%)

Insurance Median: $11,884 (84%)

Cash: $33,908 (240% of Medicare)

Ins. Median: $11,884 (84% 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
Cigna	$11,648	83%
Nhc Advantage Alt Payer [6101]	$11,648	83%
Nhc Advantage [61]	$11,648	83%
UnitedHealthcare	$11,648 - $11,884	83%
Absolute Total Care Mcr Plans Alt Payer [4101]	$11,884	84%
Absolute Total Care Mcr Plans [41]	$11,884	84%
Aetna	$11,884	84%
Ambetter / Centene	$11,884	84%
Blue Cross Blue Shield	$11,884 - $34,637	84%
Bright Health Alt Payer [1001]	$11,884	84%
Champva [604]	$11,884	84%
Continental Life Ins Co [7]	$11,884	84%
Devoted Health Alt Payer [9401]	$11,884	84%
Devoted Health [94]	$11,884	84%
Edison Health Solutions [95]	$11,884	84%
First Choice Next [96]	$11,884	84%
First Choice Vip Careplus Alt Payer [3301]	$11,884	84%
First Choice Vip [33]	$11,884	84%
Healthscope [98]	$11,884	84%
Humana	$11,884	84%
Medicare (plans)	$11,884	84%
Molina Dual Options [15]	$11,884	84%
Molina Marketplace [97]	$11,884	84%
Mutual Of Omaha [107]	$11,884	84%
Tricare	$11,884	84%
Vaccn - Va Community Care Network [16]	$11,884	84%
Veterans Administration [633]	$11,884	84%
Workers Compensation [622]	$11,884	84%
Bright Health [11]	$29,432	208%

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 $33,908.
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 Cannon Memorial 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.