Sepsis treatment (inpatient stay)
Facility: Oakleaf Surgical Hospital
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $13,756
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.97x 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 | $13,756 | 97% |
| Dean Health Plan | $13,756 | 97% |
| Group Health Cooperative Of Eau Claire | $13,756 | 97% |
| Healthpartners | $13,756 | 97% |
| Humana | $13,756 | 97% |
| Medica | $13,756 | 97% |
| Quartz Health Solutions | $13,756 | 97% |
| Security Health Plan Of Wi | $13,756 | 97% |
| Ucare Wi | $13,756 | 97% |
| UnitedHealthcare | $13,756 | 97% |
Consumer Guidance & Cost Commentary
For the procedure of Sepsis treatment (inpatient stay) at Oakleaf Surgical Hospital in Altoona, WI, there is no available state or county average data to compare against. The facility's negotiated rate for this service is $13,756, which is lower than the Medicare amount of $14,116.91. This suggests that the facility's contract with commercial payers results in a lower cost for in-network members compared to the federal benchmark, a common occurrence where network agreements provide better value than the standard government reimbursement rate.
Because the negotiated rate is already below the Medicare amount, patients with high-deductible plans may find that paying the cash price directly is not the most cost-effective option, as the insurance negotiated ceiling is the primary pricing driver. It is important to note that while the data shows a uniform rate of $13,756 across all ten payers listed, including Blue Cross Blue Shield, Humana, and UnitedHealthcare, patients should still verify self-pay or prompt-pay discounts directly with the hospital before scheduling. These upfront payment incentives can sometimes offer additional reductions, bypassing the administrative costs and claim processing fees that typically inflate commercial rates above the true cost of care.