Sepsis treatment (inpatient stay)
Facility: Lindsborg Community Hospital
Billing Code: 871 (MS-DRG)
- CPT Billing Code: 871
- Insurance Median: $17,469
- Cash Discount Price: $13,364
- vs. Medicare Baseline: 1.24x 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 |
|---|---|---|
| Tricare | $8,490 | 60% |
| Coventry Mcr Adv | $8,575 | 61% |
| Blue Cross Blue Shield | $15,888 | 113% |
| Cigna | $16,228 | 115% |
| Coventry Comm-All Other Plans | $17,182 | 122% |
| UnitedHealthcare | $17,182 | 122% |
| Phcs Preferred-All Plans | $17,755 | 126% |
| Multiplan-All Plans | $17,755 | 126% |
| Coventry Wc | $18,137 | 128% |
| Health Partners -All Plans | $18,137 | 128% |
| Century Health-All Plans | $18,137 | 128% |
| Wppa-All Plans | $18,519 | 131% |
Consumer Guidance & Cost Commentary
For this inpatient sepsis treatment at Lindsborg Community Hospital in Kansas, the facility's cash price of $13,364 is lower than the state average, making it a potentially cost-effective option for patients with high-deductible plans who may not utilize insurance coverage. While the median negotiated rate for commercial payers sits at $17,755, which is 25% higher than the cash price, patients should verify their specific plan's deductible status before scheduling, as paying out-of-pocket could result in lower out-of-pocket costs if the insurance allowed amount exceeds the cash rate. It is also important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request a prompt-pay discount if they choose to pay in full upfront, which can significantly reduce the final bill.
The facility's pricing is benchmarked against Medicare, which sets the standard cost for this procedure at $14,116.91. The hospital's cash rate is slightly below the Medicare amount, whereas the median negotiated rate for commercial insurance is approximately 25% higher than the Medicare benchmark. This markup reflects the administrative costs and contract structures inherent in commercial insurance billing, which often exceed the true cost of care. Consumers are advised to ignore the hospital's gross charge of $19,091 as a benchmark and instead compare the cash or negotiated rates directly to the Medicare amount to understand the actual value of the service. Additionally, since this is a Critical Access Hospital, patients should confirm whether the facility offers self-pay or prompt-pay discounts before registration to ensure they are receiving the most favorable rate available.