CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: St Lucie Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $16,724
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at St Lucie Medical Center is $16,724. 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 1.18x the Medicare baseline. Located in 1800 Se Tiffany Ave, Port Saint Lucie, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,724

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: $16,724 (118%)
Ins. Median: $16,724 (118% 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 - $17,046 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 - $19,685 43%
Vitas Healthcare $15,277 108%
Wellmed $15,599 110%
United Behavioral Health $16,081 114%
Veterans Evaluation Services $16,081 114%
Blue Cross Blue Shield $16,242 - $33,142 115%
Devoted Health $16,403 116%
Ultimate Health Plan $16,403 116%
Aetna $16,483 - $50,326 117%
Freedom Health $16,724 118%
Health Sun Health Plan $16,724 118%
Optimum $16,724 118%
Careplus $16,885 - $18,493 120%
American Health Plan $17,046 121%
Florida Complete Care $17,046 121%
Longevity Health Plan $17,046 121%
Sunshine State $17,207 - $17,689 122%
Simply Healthcare Plans $17,367 123%
Centurion $17,689 125%
Solis Health Plan $18,332 130%
Ndms Definitive Care $20,101 142%
Oscar $25,491 181%
Simply Healthcare $65,667 465%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1800 Se Tiffany Ave, Port Saint Lucie, FL 34952
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals