CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: HCA Florida Capital Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $18,147
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at HCA Florida Capital Hospital is $18,147. 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 1.29x the Medicare baseline. Located in 2626 Capital Medical Blvd, Tallahassee, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,147

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: $18,147 (129%)

Ins. Median: $18,147 (129% 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
Molina Healthcare	$2,201 - $18,147	16%
Sunshine State Health Plan	$2,336 - $11,680	17%
Cigna	$2,374 - $92,215	17%
Avmed	$2,968 - $32,131	21%
Humana	$4,741 - $18,147	34%
United	$5,314 - $17,119	38%
Wellmed	$16,777	119%
United Behavioral Health	$17,119	121%
Blue Cross Blue Shield	$17,291 - $28,965	122%
Ultimate Health Plan	$17,462	124%
Aetna	$17,547 - $39,599	124%
Simply	$17,975	127%
American Health Plan	$18,147	129%
Sunshine State	$18,403	130%
Wellcare	$18,403	130%
Gold Kidney Of Florida	$18,660	132%
Align Senior Care	$18,831	133%
Centurion	$18,831	133%
Florida Complete Care	$18,831	133%
Longevity Health Plan	$18,831	133%
Gadsden County Jail	$21,399	152%
Ndms Definitive Care	$21,399	152%
Physician Network Association	$22,255	158%
Oscar	$24,190	171%
Naphcare	$27,391	194%
Simply Healthcare	$45,262	321%

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 Capital 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.