CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Raleigh General Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $13,821
  • Cash Discount Price: $16,195
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Raleigh General Hospital is $13,821. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,195. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.98x the Medicare baseline. Located in 1710 Harper Road, Beckley, WV.
Cash / Self-Pay
$16,195

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,821

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: $16,195 (115%)
Insurance Median: $13,821 (98%)
Cash: $16,195 (115% of Medicare)
Ins. Median: $13,821 (98% 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.

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
Peia $10,881 77%
Advantra $13,821 98%
Aetna $13,821 98%
Black Lung $13,821 98%
Blue Cross Blue Shield $13,821 - $37,858 98%
Coventry $13,821 98%
Humana $13,821 98%
Medicare (plans) $13,821 98%
Pyramid $13,821 98%
UnitedHealthcare $13,821 98%
Tricare $14,670 104%
Caresource $29,025 206%
Employee Benefit Consultants $42,013 298%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1710 Harper Road, Beckley, WV 25801
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals