CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Prisma Health Greenville Memorial Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $17,620
  • Cash Discount Price: $38,361
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Prisma Health Greenville Memorial Hospital is $17,620. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38,361. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.25x the Medicare baseline. Located in 701 Grove Road, Greenville, SC.
Cash / Self-Pay
$38,361

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,620

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: $38,361 (272%)
Insurance Median: $17,620 (125%)
Cash: $38,361 (272% of Medicare)
Ins. Median: $17,620 (125% 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
Medicaid / KanCare $5,976 42%
UnitedHealthcare $5,976 - $17,368 42%
First Choice Benefits Mgmt [3074] $9,803 69%
Medicare (plans) $9,803 - $18,459 69%
Golden Rule Insurance Company [2991] $10,303 73%
Oxford Health Plans [2992] $10,303 73%
Zzumr-Salt Lake City Ut [3169] $10,303 73%
Humana $12,789 - $13,040 91%
Blue Cross Blue Shield $15,696 - $32,180 111%
Champva [3049] $16,781 119%
Cigna $16,781 - $39,676 119%
Deseret Mutual Ins Co [3066] $16,781 119%
Generic Skilled Nursing [3196] $16,781 119%
Hospice Contracted [1500] $16,781 119%
Hospice Non Contracted [3190] $16,781 119%
Veterans Administration [3194] $16,781 119%
Aetna $17,620 125%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $17,620 125%
Healthy Conn Prime-First Choice Vip Care [5300] $17,788 126%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $17,916 127%
Triwest Healthcare Alliance Vcp [902] $17,916 127%
Va Community Care Network-Vaccn [903] $17,916 127%
Healthy Conn Prime-Molina Healthcare [5330] $18,459 131%
Bluechoice [810] $18,720 - $32,472 133%
Scdc-Sc Dept Of Corrections [7232] $20,745 147%
Workers Comp [600] $23,493 166%
Bob Jones Univ-Pai [821] $27,656 196%
Planned Administrators [820] $32,180 228%
Preferred Administrators Contracted [2839] $34,495 244%
Promise Health Plan Contracted [2401] $37,879 268%
Evernorth Behavioral Contracted [2982] $39,676 281%
Mvp Health Care [3037] $39,676 281%
Ambetter / Centene $47,119 334%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Grove Road, Greenville, SC 29605
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals