CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: HCA Florida Raulerson Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $15,197
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at HCA Florida Raulerson Hospital is $15,197. 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 1.08x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,197

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: $15,197 (108%)
Ins. Median: $15,197 (108% 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
Avmed $1,715 - $28,672 12%
Molina $1,834 - $15,342 13%
Sunshine State Health Plan $2,331 - $11,652 17%
Cigna $4,535 - $47,394 32%
Humana $4,630 - $68,518 33%
United $6,000 - $14,473 43%
Wellmed $14,039 99%
Veterans Evaluation Services $14,473 103%
Blue Cross Blue Shield $14,618 - $33,142 104%
Devoted Health $14,763 105%
Ultimate Health Plan $14,763 105%
Aetna $14,835 - $50,326 105%
Freedom Health $15,052 107%
Health Sun Health Plan $15,052 107%
Optimum $15,052 107%
Careplus $15,197 - $16,644 108%
Simply Healthcare Plans $15,197 108%
American Health Plan $15,342 109%
Sunshine State $15,486 - $15,921 110%
Centurion $15,921 113%
Florida Complete Care $15,921 113%
Longevity Health Plan $15,921 113%
Solis Health Plan $16,500 117%
Ndms Definitive Care $18,092 128%
Oscar $25,491 181%
Simply Healthcare $65,667 465%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1796 Hwy 441 North, Okeechobee, FL 34972
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals