CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: HCA Florida Highlands Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $15,986
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at HCA Florida Highlands Hospital is $15,986. 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 1.13x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,986

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: $15,986 (113%)
Ins. Median: $15,986 (113% 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
Avmed $1,715 - $28,672 12%
Cigna $4,535 - $47,394 32%
Humana $4,630 - $68,518 33%
United $6,000 - $15,371 43%
Wellmed $14,910 106%
Blue Cross Blue Shield $15,525 - $33,142 110%
Sunshine State $15,525 - $16,908 110%
Devoted Health $15,679 111%
Florida Complete Care $15,679 111%
Longevity Health Plan $15,679 111%
Aetna $15,755 - $50,326 112%
Freedom Health $15,986 113%
Prominence Healthfirst $15,986 113%
American Health Plan $16,293 115%
Molina $16,293 115%
Centurion $16,908 120%
Ndms Definitive Care $19,214 136%
Oscar $25,491 181%
Simply Healthcare $65,667 465%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals