CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Physicians Regional Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $13,935
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Physicians Regional Medical Center is $13,935. 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 0.99x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,935

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: $13,935 (99%)
Ins. Median: $13,935 (99% 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 $1,459 10%
UnitedHealthcare $1,459 - $15,357 10%
Novanet Work Comp Tn $1,913 14%
Occunet Work Comp Tn $1,932 14%
Tn Work Comp $1,932 14%
Blue Cross Blue Shield $4,017 - $18,036 28%
Amerigroup $6,586 - $14,205 47%
Amerigroup Community Care $6,586 47%
Node Bluecare Plus Tn Mcr Adv $12,370 - $12,587 88%
Humana $13,498 - $13,530 96%
Medicare (plans) $13,530 - $14,255 96%
Self Pay $13,684 - $14,244 97%
Node Farm Bureau Mcr Adv $13,767 98%
Aetna $13,935 - $18,576 99%
Node Healthspring Mcr Adv $13,935 99%
Wellcare $14,288 101%
Node Va $14,511 - $14,801 103%
Node Devoted Health Mcr Adv $14,540 103%
Node Nhc Mcr Adv $14,880 105%
Node Us Dept Of Labor $21,024 149%
Us Department Of Labor $21,024 149%
Node Point Comfort Underwriters $25,477 - $26,845 180%
Ambetter / Centene $26,845 190%
Multiplan $33,960 - $44,651 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals