CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Carilion Medical Center

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$17,658

about 1.3× the $14,117 Medicare rate · typically $15,554–$24,136

modeled estimate · not a bill or quote

What this hospital charges insurers

$17,086

About the fair price

about $572 under the fair price · 1.2× Medicare

Medicare pays $14,117 Fair price $17,658 This hospital $17,086 Cash price $25,720 Hospital's list price $73,485

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

Highest price of the 9 VA hospitals we have prices for — worth calling around.

Cheapest $10,776 Priciest $17,086

Black dot = this hospital, among the 9 VA hospitals with a price for this procedure. Full list below.

A fair price for a Sepsis treatment (inpatient stay) is about $17,658 (about 1.3× the $14,117 Medicare rate). Carilion Medical Center charges insurers about $17,086, or about $25,720 in cash — about the fair price. Located in Roanoke, VA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$17,086 - $60,066	121%
Blue Cross Blue Shieldmajor	$16,920 - $48,704	120%
Aetnamajor	$15,593 - $48,794	110%
Cignamajor	$49,529 - $52,909	351%
Humanamajor	$16,256 - $49,508	115%
Sentara	$17,418 - $45,561	123%
+ 8 smaller / regional plans	$45,561 - $69,810

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 25,720), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 871.

Insurance Before you use insurance

Call your insurance company to confirm Carilion Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 871.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Carilion Medical Center

Compare: Sepsis treatment (inpatient stay) at other VA hospitals

Childrens Hospital of the Kings Daughters Inc · Norfolk $10,776
Sentara Rmh Medical Center · Harrisonburg $14,559
Lewisgale Hospital Alleghany · Low Moor $14,635
Buchanan General Hospital · Grundy $14,876
Sentara Halifax Regional Hospital · South Boston $15,094
Sovah Health Danville · Danville $15,113
Lewisgale Hospital Pulaski · Pulaski $15,216
Clinch Valley Medical Center · Richlands $15,240

Insurance negotiated median for the same procedure, sorted lowest first.