CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: St Nicholas Hospital

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$27,147

about 1.9× the $14,117 Medicare rate · typically $16,690–$32,440

modeled estimate · not a bill or quote

What this hospital charges insurers

$28,166

About the fair price

about $1,019 over the fair price · 2.0× Medicare

Medicare pays $14,117 Fair price $27,147 This hospital $28,166 Cash price $28,761 Hospital's list price $43,577

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

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

Cheapest $7,995 Priciest $28,166

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

A fair price for a Sepsis treatment (inpatient stay) is about $27,147 (about 1.9× the $14,117 Medicare rate). St Nicholas Hospital charges insurers about $28,166, or about $28,761 in cash — about the fair price. Located in Sheboygan, WI.

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	$14,687 - $33,264	104%
Blue Cross Blue Shieldmajor	$14,687 - $42,976	104%
Aetnamajor	$14,687 - $43,577	104%
Cignamajor	$30,504	216%
Humanamajor	$14,687 - $37,040	104%
Health Net	$28,166	200%
Medica	$14,687	104%
Molina	$14,687 - $21,788	104%
Security Health Plan	$14,834 - $27,815	105%
+ 13 smaller / regional plans	$23,619 - $43,577

Government programs also on file: Medicare.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 28,761), 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 St Nicholas Hospital 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 St Nicholas Hospital

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

Thedacare Medical Center - New London · New London $7,995
Vernon Memorial Hospital · Viroqua $9,838
Memorial Hospital of Lafayette County · Darlington $11,896
Orthopaedic Hospital of Wisconsin · Glendale $13,315
Sauk Prairie Hospital · Prairie Du Sac $13,730
Oakleaf Surgical Hospital · Altoona $13,756
The Monroe Clinic · Monroe $13,815
Mile Bluff Medical Center · Mauston $13,970

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