CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: HCA Florida North Florida Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $18,061
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at HCA Florida North Florida Hospital is $18,061. 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 1.28x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,061

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: $18,061 (128%)

Ins. Median: $18,061 (128% 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	$1,498 - $34,059	11%
Molina Healthcare	$2,201 - $19,049	16%
Sunshine State Health Plan	$2,336 - $11,680	17%
Cigna	$2,374 - $92,271	17%
Humana	$4,954 - $19,229	35%
United	$6,086 - $17,971	43%
Blue Cross Blue Shield	$15,781 - $23,824	112%
Oscar	$16,092	114%
Hospice Of North Central Fl	$16,174	115%
Wellmed	$17,612	125%
United Behavioral Health	$17,971	127%
Va Purchased Care Program	$17,971	127%
Capital Health Plan	$18,151 - $30,381	129%
Ultimate Health Plan	$18,330	130%
Aetna	$18,420 - $33,285	130%
Simply	$18,870	134%
American Health Plan	$19,049	135%
Sunshine State	$19,319	137%
Wellcare	$19,319	137%
Gold Kidney Of Florida	$19,588	139%
Centurion	$19,768	140%
Longevity Health Plan	$20,128	143%
Align Senior Care	$21,206	150%
Florida Complete Care	$21,206	150%
Ndms Definitive Care	$22,464	159%
Evolutions	$31,482	223%
Corizon Phs	$35,942	255%
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 North Florida 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.