CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Coral Gables Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $17,050
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Coral Gables Hospital is $17,050. 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 1.21x the Medicare baseline. Located in 3100 Douglas Rd, Coral Gables, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,050

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: $17,050 (121%)
Ins. Median: $17,050 (121% 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 - $16,238 15%
Dimension Health Wc $2,283 16%
Workers Compensation $2,283 16%
Humana $3,350 - $15,913 24%
Veterans Administration Mill Bill $11,366 81%
Bc/Bs Of Fl Miami Dade Blue Select $13,193 93%
Medicare (plans) $15,426 - $35,550 109%
Leon Health Inc $16,204 115%
Devoted Health $16,238 115%
UnitedHealthcare $16,238 - $34,405 115%
Veterans Administration Vaccn $16,535 117%
Cigna $17,050 - $24,526 121%
Florida Pace Centers $17,050 121%
Healthsun Health Plans $17,050 121%
Longevity Health Plan $17,279 122%
Oscar Health Plan Hix $18,498 131%
Bc/Bs Myblue Hmo Hix $19,145 136%
Bc/Bs Of Fl Health Options Hmo $19,145 136%
Bc/Bs Of Fl Simplyblue $19,145 136%
Bright Health Management Commercial $19,842 141%
Self Pay/Uninsured $20,297 144%
Employer Direct Healthcare $20,669 146%
Bc/Bs Of Fl Network Blue $21,045 149%
Molina Marketplace Program Exchange $21,173 150%
Naphcare Inc $22,733 161%
Bc/Bs Of Fl Blue Select Exchange Non Par $23,148 164%
Avmed Broad Network $24,370 173%
Imagine Health $25,721 182%
Avmed Exchange $28,936 205%
Ambetter / Centene $30,590 217%
Bc/Bs Of Fl Phs $32,430 230%
Bc/Bs Of Fl Ppo $32,430 230%
Auto Insurance $33,070 234%
Avmed Select Network $33,775 239%
Amerihealth Caritas Next Exchange $35,550 252%
Tricare $44,022 312%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Douglas Rd, Coral Gables, FL 33134
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals