CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $18,460
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Central Florida Lake Monroe Hospital is $18,460. 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 1.31x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,460

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: $18,460 (131%)
Ins. Median: $18,460 (131% 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
Molina Healthcare $2,201 - $18,460 16%
Sunshine State Health Plan $2,348 - $11,736 17%
Cigna $2,834 - $43,024 20%
Avmed $2,968 - $33,375 21%
United $4,328 - $17,415 31%
Humana $7,247 - $24,846 51%
Wellmed $17,066 121%
Truli For Health $17,408 123%
Blue Cross Blue Shield $17,589 - $30,630 125%
Fl Health Care Plan $17,589 125%
Devoted Health $17,763 126%
Ultimate Health Plan $17,763 126%
Aetna $17,850 - $39,146 126%
Clear Spring Health $17,937 127%
Freedom Health $18,111 128%
Optimum $18,111 128%
Simply $18,285 130%
American Health Plan $18,460 131%
Solis Health Plan $18,634 132%
Sunshine State $18,721 133%
Wellcare $18,721 133%
Longevity Health Plan $18,808 133%
Careplus $18,982 - $20,027 134%
Gold Kidney Of Florida $18,982 134%
Align Senior Care $19,156 136%
Centurion $19,156 136%
Florida Complete Care $19,156 136%
Seminole County Sheriffs Office $19,156 136%
Ndms Definitive Care $21,768 154%
Oscar $26,364 187%
Florida Health Care Plan $31,127 220%
Evolutions $31,482 223%
Simply Healthcare $45,262 321%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals