CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Carilion New River Valley Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $43,765
Cash Discount Price: $22,727
vs. Medicare Baseline: 3.10x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Carilion New River Valley Medical Center is $43,765. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22,727. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 3.10x the Medicare baseline. Located in 2900 Lamb Circle, Christiansburg, VA.

Cash / Self-Pay

$22,727

Average discount available for prompt cash payment at this facility.

Insurance Median

$43,765

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: $22,727 (161%)

Insurance Median: $43,765 (310%)

Cash: $22,727 (161% of Medicare)

Ins. Median: $43,765 (310% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 310% of the Medicare baseline (a markup of 210%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$17,050 - $43,116	121%
Humana	$17,776 - $49,508	126%
Blue Cross Blue Shield	$18,501 - $60,383	131%
UnitedHealthcare	$18,683 - $53,076	132%
Sentara Health Plan	$19,046 - $40,259	135%
Vhn - Ultra	$40,259	285%
Cigna	$43,765 - $46,752	310%
Gateway - Tier 3	$44,155	313%
Connecticare	$45,453	322%
Vhn - Plus	$49,999	354%
Gateway - Tier 2	$51,947	368%
Vhn	$51,947	368%
Vhn - Link	$58,440	414%
Gateway - Tier 1	$61,687	437%
Vhn - Secondary Payors	$61,687	437%

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 $22,727.
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 Carilion New River Valley Medical Center 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.