CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Palmetto General Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $18,641
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Palmetto General Hospital is $18,641. 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 1.32x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,641

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: $18,641 (132%)
Ins. Median: $18,641 (132% 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.

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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 - $18,302 15%
Dimension Health Wc $2,283 16%
Workers Compensation $2,283 16%
Humana $5,349 - $17,962 38%
Veterans Administration Mill Bill $13,205 94%
Bc/Bs Of Fl Miami Dade Blue Select $14,981 106%
Medicare (plans) $16,651 - $38,540 118%
Leon Health Inc $18,295 130%
Devoted Health $18,302 130%
UnitedHealthcare $18,302 - $42,735 130%
Cigna $18,640 - $24,526 132%
Ima Evalutations Inc $18,641 132%
Opuscare Of South Fl $18,641 132%
Veterans Administration Vaccn $18,641 132%
Westchester General Hospital $18,641 132%
Florida Pace Centers $19,151 136%
Healthsun Health Plans $19,151 136%
Longevity Health Plan $19,506 138%
Oscar Health Plan Hix $20,280 144%
Bc/Bs Myblue Hmo Hix $20,477 145%
Bc/Bs Of Fl Health Options Hmo $20,477 145%
Bc/Bs Of Fl Simplyblue $20,477 145%
Molina Marketplace Program Exchange $21,173 150%
Bright Health Management Commercial $22,102 157%
Self Pay/Uninsured $22,877 162%
Employer Direct Healthcare $22,967 163%
Bc/Bs Of Fl Network Blue $23,414 166%
Avmed Broad Network $24,968 177%
Naphcare Inc $25,097 178%
Bc/Bs Of Fl Blue Select Exchange Non Par $25,755 182%
Imagine Health $28,005 198%
Avmed Exchange $31,619 224%
Bc/Bs Of Fl Phs $32,414 230%
Bc/Bs Of Fl Ppo $32,414 230%
Ambetter / Centene $33,349 236%
Auto Insurance $34,607 245%
Avmed Select Network $36,649 260%
Amerihealth Caritas Next Exchange $38,540 273%
Tricare $44,022 312%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2001 W 68Th St, Hialeah, FL 33016
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals