CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Uva Health Haymarket Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $16,436
Cash Discount Price: $25,021
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Uva Health Haymarket Medical Center is $16,436. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,021. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.16x the Medicare baseline. Located in 15225 Healthcote Boulevard, Haymarket, VA.

Cash / Self-Pay

$25,021

Average discount available for prompt cash payment at this facility.

Insurance Median

$16,436

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: $25,021 (177%)

Insurance Median: $16,436 (116%)

Cash: $25,021 (177% of Medicare)

Ins. Median: $16,436 (116% 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.

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
Commonwealth Attorney [99931]	$2,278 - $2,350	16%
Tdo [99908]	$2,278 - $2,350	16%
UnitedHealthcare	$4,735 - $48,355	34%
Aetna	$7,700 - $16,601	55%
Humana	$14,442 - $16,353	102%
Blue Ridge Pace [10510]	$14,718	104%
Medicaid / KanCare	$14,718	104%
Veterans [99909]	$15,535	110%
Blue Cross Blue Shield	$16,024 - $39,557	114%
Cigna	$16,024 - $50,163	114%
Medicare (plans)	$16,024 - $16,436	114%
VA Ccn [99926]	$16,024 - $22,237	114%
VA Ccn [99927]	$16,024 - $22,237	114%
Veterans Administration [99910]	$16,024 - $16,436	114%
HMO Part B [10099]	$16,353	116%
Geha [40009]	$22,727 - $39,186	161%
Carefirst [30007]	$26,243 - $29,151	186%
Sentara [40021]	$39,262 - $44,042	278%
Sentara Behavioral Health [40052]	$44,042	312%

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 $25,021.
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 Uva Health Haymarket 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.