CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Lafollette Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $14,788
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Lafollette Medical Center is $14,788. 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 1.05x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,788

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: $14,788 (105%)
Ins. Median: $14,788 (105% 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
Beech Street Work Comp Tn $1,913 14%
Novanet Work Comp Tn $1,913 14%
Tn Work Comp $1,932 14%
Bluecare $3,409 - $6,876 24%
Blue Cross Blue Shield $3,929 - $19,592 28%
Amerigroup $6,604 47%
Aetna $7,891 - $39,116 56%
Medicaid / KanCare $7,891 56%
UnitedHealthcare $7,891 - $16,581 56%
Wellcare $7,891 56%
Humana $8,119 - $14,788 58%
Node Bluecare Plus Tn Mcr Adv $12,625 89%
Triwest $14,753 105%
Medicare (plans) $14,788 105%
Node Wellcare Mcr Adv $15,054 107%
Node Devoted Health Mcr Adv $15,083 107%
Node Farm Bureau Mcr Adv $15,083 107%
Node Blueadvantage Mcr Adv $15,230 108%
Node Healthspring Mcr Adv $15,230 108%
Node Va $15,355 109%
Node Amerigroup Mcr Adv $15,525 110%
Windsor Health Plan $15,525 110%
Node Nhc Mcr Adv $16,263 115%
Self Pay $18,055 128%
Node Us Dept Of Labor $21,748 154%
Ambetter / Centene $27,850 197%
Node Point Comfort Underwriters $33,119 235%
Multiplan Complementary $47,795 339%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals