Sepsis treatment (inpatient stay)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $8,212
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.58x 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 |
|---|---|---|
| UnitedHealthcare | $7,821 | 55% |
| Aetna | $8,134 | 58% |
| Medicaid / KanCare | $8,134 - $8,212 | 58% |
| Smarthealth | $15,276 | 108% |
| Blue Cross Blue Shield | $18,620 - $19,600 | 132% |
Consumer Guidance & Cost Commentary
For the procedure code 871, representing sepsis treatment in an inpatient stay at Ascension Via Christi Hospital Manhattan, Inc, the negotiated rates vary significantly by payer. While UnitedHealthcare and Aetna have a single fixed rate of $7,821 and $8,134 respectively, Medicaid/KanCare plans range from $8,134 to $8,212, and Smarthealth rates are $15,276. Blue Cross Blue Shield offers the highest range, from $18,620 to $19,600 across two plans. These commercial rates are notably higher than the Medicare benchmark of $14,116.91, which serves as the federal baseline for this service. Patients should be aware that while in-network coverage protects against balance billing under the No Surprises Act, the actual amount paid by the insurer is often higher than the cash price due to administrative costs and contract structures.
It is important to note that cash payments or prompt-pay discounts may result in lower out-of-pocket costs for patients with high-deductible plans, as the facility's cash median is not listed but could theoretically be lower than the negotiated rates exceeding $15,000. Before scheduling, patients should explicitly request self-pay or prompt-pay discounts, which can range from 20% to 50% off the billed amount, to avoid paying the full negotiated rate if their insurance deductible has not yet been met. Additionally, since the facility is a voluntary non-profit in Manhattan, KS, and operates under the MS-DRG system, consumers should verify their specific plan's allowed amount before arrival to ensure they