CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Lakeside Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $31,365
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.22x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Lakeside Medical Center is $31,365. 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 2.22x the Medicare baseline. Located in 39200 Hooker Hwy, Belle Glade, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$31,365

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: $31,365 (222%)

Ins. Median: $31,365 (222% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 222% of the Medicare baseline (a markup of 122%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$8,306 - $31,365	59%
Geo	$29,797	211%
Aetna	$31,365	222%
Care Plus	$31,365	222%
Cigna	$31,365	222%
Glade Sheriffs	$31,365	222%
Humana	$31,365	222%
Molina	$31,365 - $32,933	222%
Simply Healthcare	$31,365	222%
UnitedHealthcare	$31,365	222%
Wellpath	$31,365	222%
Ambetter / Centene	$32,933	233%
Sunshine	$32,933	233%
Wellcare	$32,933	233%
Devoted	$33,560	238%
Genesys	$34,501	244%
Prime Health Plan	$34,501	244%

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 Lakeside Medical Center 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.