CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: HCA Florida Lake City Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $16,092
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at HCA Florida Lake City Hospital is $16,092. 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 1.14x the Medicare baseline. Located in 340 Nw Commerce Dr, Lake City, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$16,092

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: $16,092 (114%)

Ins. Median: $16,092 (114% 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
Avmed	$1,717 - $32,131	12%
Molina Healthcare	$2,201 - $13,318	16%
Sunshine State Health Plan	$2,336 - $11,680	17%
Cigna	$2,374 - $92,271	17%
Humana	$4,954 - $17,834	35%
United	$5,063 - $15,193	36%
Hospice Of North Central Fl	$13,674	97%
Wellmed	$14,889	105%
Blue Cross Blue Shield	$15,345 - $35,659	109%
Ultimate Health Plan	$15,497	110%
Aetna	$15,573 - $33,285	110%
Simply	$15,953	113%
Oscar	$16,092	114%
American Health Plan	$16,105	114%
Sunshine State	$16,333	116%
Wellcare	$16,333	116%
Gold Kidney Of Florida	$16,561	117%
Centurion	$16,713	118%
Longevity Health Plan	$17,017	121%
Align Senior Care	$17,472	124%
Florida Complete Care	$17,472	124%
Ndms Definitive Care	$18,992	135%
Evolutions	$31,482	223%
Simply Healthcare	$36,358	258%

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 Lake City 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.