Sepsis treatment (inpatient stay)
Facility: Orthopaedic Hospital of Wisconsin
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $13,315
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.94x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $13,315 | 94% |
| Humana | $13,315 | 94% |
| Medicare (plans) | $13,315 | 94% |
| UnitedHealthcare | $13,315 | 94% |
| Molina - Exchange | $29,293 | 208% |
Consumer Guidance & Cost Commentary
For the procedure "Sepsis treatment (inpatient stay)" at Orthopaedic Hospital Of Wisconsin in Glendale, WI, the median negotiated rate is $13,315. This facility, owned by physicians, has a contract with five payers, including Blue Cross Blue Shield, Humana, Medicare, UnitedHealthcare, and Molina. While the negotiated rate is consistent across most of these plans, Molina - Exchange negotiates a distinct rate of $29,293, which is significantly higher than the other carriers.
It is important to note that the cash median price is not available for this service, and the facility does not currently list a specific state or county average for comparison. However, patients should be aware that cash-pay options can sometimes be cheaper than insurance negotiated rates if a patient has a high-deductible plan where the insurer's allowed amount exceeds the cash price. To secure the lowest possible cost, consumers should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, as these upfront payment incentives can reduce the total bill by bypassing administrative claim processing fees.