CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: HCA Florida Twin Cities Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $15,441
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at HCA Florida Twin Cities Hospital is $15,441. 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 1.09x the Medicare baseline. Located in 2190 Hwy 85 N, Niceville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,441

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: $15,441 (109%)

Ins. Median: $15,441 (109% 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
Molina Healthcare	$2,201 - $15,441	16%
Sunshine State Health Plan	$2,348 - $11,736	17%
Cigna	$2,374 - $92,215	17%
Avmed	$2,968 - $32,131	21%
Humana	$6,935 - $23,776	49%
United	$7,876 - $21,500	56%
Wellmed	$14,275	101%
Regency Hospice	$14,567	103%
Blue Cross Blue Shield	$14,712 - $35,659	104%
Ultimate Health Plan	$14,858	105%
Aetna	$14,931 - $69,204	106%
Simply	$15,295	108%
American Health Plan	$15,441	109%
Healthspring Of Florida	$15,587	110%
Sunshine State	$15,659	111%
Wellcare	$15,659	111%
Gold Kidney Of Florida	$15,878	112%
Centurion	$16,024	114%
Florida Complete Care	$16,315	116%
Longevity Health Plan	$16,315	116%
Ndms Definitive Care	$18,209	129%
Oscar	$22,086	156%
Simply Healthcare	$45,262	321%

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 HCA Florida Twin Cities Hospital 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.