CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Shands Jacksonville

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $25,075
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.78x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Shands Jacksonville is $25,075. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.78x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,075

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%)

Insurance Median: $25,075 (178%)

Ins. Median: $25,075 (178% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Capital Health Plan	$8,316	59%
Health First Health Plan	$10,587 - $11,072	75%
Blue Cross Blue Shield	$16,860 - $30,692	119%
Aetna	$20,022 - $22,905	142%
Avmed	$22,990 - $26,073	163%
Truli For Health	$23,396	166%
Ameri-Plus Preferred Care	$24,110	171%
Humana	$24,110 - $24,351	171%
Beacon Health Strategies	$24,834	176%
Careplus Health Plan	$24,834	176%
Florida Health Care Plan	$24,834 - $30,886	176%
UnitedHealthcare	$25,075	178%
Devoted Health Plan	$25,316 - $26,521	179%
Florida Complete Care	$26,521	188%
Positive Healthcare Partners	$26,521	188%
Wellcare Of Florida	$28,209	200%
Cigna	$28,283	200%
Molina	$29,867	212%
Volusia Health Network	$36,760	260%
Wellpath	$36,760	260%
Ambetter / Centene	$38,138	270%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 871.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Shands Jacksonville is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 871.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.