Sepsis treatment (inpatient stay)
Facility: Salina Regional Health Center
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $45,217
- Cash Discount Price: $35,169
- vs. Medicare Baseline: 3.20x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 320% of the Medicare baseline (a markup of 220%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $15,547 - $16,365 | 110% |
| Preferred Phsic | $30,145 | 214% |
| Preferred Healthcare - All Other Plans | $40,696 | 288% |
| Providers Care (Wppa)-All Plans | $45,217 | 320% |
| Aetna | $45,217 | 320% |
| Cigna | $45,217 | 320% |
| Multiplan (Mpi)-All Plans | $45,217 | 320% |
Consumer Guidance & Cost Commentary
For the procedure code 871, representing sepsis treatment at Salina Regional Health Center in Salina, Kansas, the facility's cash median price is $35,169.00, which is notably lower than the facility's negotiated rates of $45,217.00 and the gross charge of $50,242.00. While the facility's negotiated rate of $45,217.00 aligns with the median negotiated rate across all payers, it is significantly higher than the Medicare benchmark of $14,116.91, reflecting a markup common in commercial billing. Patients with high-deductible plans or those who have met their out-of-pocket maximums may find paying the cash price of $35,169.00 more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash price due to administrative overhead and contract structures.
It is important to note that the facility's cash rate does not appear to be compared against specific state or county averages in the provided data, so no direct regional comparison can be made. However, the facility operates as a voluntary non-profit acute care hospital and offers a facility rating of 3. To minimize costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. Additionally, if you have insurance, verify your deductible status before proceeding, as paying the full negotiated rate without meeting your deductible could result in higher out-of-pocket expenses than paying cash outright.