CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: North Shore Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $17,586
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at North Shore Medical Center is $17,586. 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 1.25x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,586

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: $17,586 (125%)
Ins. Median: $17,586 (125% 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
Aetna $2,169 - $16,749 15%
Dimension Health Wc $2,283 16%
Workers Compensation $2,283 16%
Humana $4,098 - $16,414 29%
Veterans Administration Mill Bill $11,724 83%
Medicare (plans) $15,911 - $36,671 113%
Leon Health Inc $16,715 118%
Devoted Health $16,749 119%
UnitedHealthcare $16,749 - $41,881 119%
Veterans Administration Vaccn $17,056 121%
Cigna $17,586 - $24,526 125%
Florida Pace Centers $17,586 125%
Healthsun Health Plans $17,586 125%
Longevity Health Plan $17,909 127%
Oscar Health Plan Hix $18,947 134%
Bc/Bs Myblue Hmo Hix $19,611 139%
Bc/Bs Of Fl Health Options Hmo $19,611 139%
Bc/Bs Of Fl Simplyblue $19,611 139%
Bright Health Management Commercial $20,468 145%
Centurion Prison $20,936 148%
Self Pay/Uninsured $20,936 148%
Molina Marketplace Program Exchange $21,173 150%
Employer Direct Healthcare $21,321 151%
Avmed Broad Network $23,391 166%
Bc/Bs Of Fl Network Blue $26,644 189%
Imagine Health $27,432 194%
Bc/Bs Of Fl Blue Select Exchange Non Par $29,307 208%
Avmed Exchange $29,849 211%
Ambetter / Centene $31,554 224%
Auto Insurance $34,113 242%
Avmed Select Network $34,838 247%
Amerihealth Caritas Next Exchange $36,671 260%
Bc/Bs Of Fl Phs $36,769 260%
Bc/Bs Of Fl Ppo $36,769 260%
Tricare $44,022 312%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals