CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Hialeah Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $18,569
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Hialeah Hospital is $18,569. 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 1.32x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,569

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: $18,569 (132%)
Ins. Median: $18,569 (132% 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 - $17,855 15%
Dimension Health Wc $2,283 16%
Workers Compensation $2,283 16%
Humana $3,599 - $17,498 25%
Veterans Administration Mill Bill $12,498 89%
Bc/Bs Of Fl Miami Dade Blue Select $14,151 100%
Medicare (plans) $16,962 - $39,097 120%
Leon Health Inc $17,821 126%
Devoted Health $17,855 126%
UnitedHealthcare $17,855 - $36,271 126%
Veterans Administration Vaccn $18,185 129%
Oscar Health Plan Hix $18,618 132%
Cigna $18,640 - $24,526 132%
Florida Pace Centers $18,747 133%
Healthsun Health Plans $18,747 133%
Bc/Bs Myblue Hmo Hix $18,821 133%
Bc/Bs Of Fl Health Options Hmo $18,821 133%
Bc/Bs Of Fl Simplyblue $18,821 133%
Longevity Health Plan $19,003 135%
Molina Marketplace Program Exchange $21,173 150%
Bright Health Management Commercial $21,822 155%
Self Pay/Uninsured $22,318 158%
Employer Direct Healthcare $22,731 161%
Avmed Broad Network $22,822 162%
Bc/Bs Of Fl Network Blue $24,634 174%
Naphcare Inc $24,997 177%
Bc/Bs Of Fl Blue Select Exchange Non Par $27,097 192%
Bc/Bs Of Fl Phs $27,106 192%
Bc/Bs Of Fl Ppo $27,106 192%
Imagine Health $29,067 206%
Avmed Exchange $31,824 225%
Ambetter / Centene $33,642 238%
Auto Insurance $36,370 258%
Avmed Select Network $37,138 263%
Amerihealth Caritas Next Exchange $39,097 277%
Tricare $44,022 312%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals