CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Physicians Regional Medical Center - Pine Ridge

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $20,777
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Physicians Regional Medical Center - Pine Ridge is $20,777. 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 1.47x the Medicare baseline. Located in 6101 Pine Ridge Road, Naples, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$20,777

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: $20,777 (147%)
Ins. Median: $20,777 (147% 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
UnitedHealthcare $8,468 - $14,326 60%
Aetna $14,074 - $45,680 100%
Blue Cross Blue Shield $14,074 - $44,656 100%
Humana $14,074 100%
Medicare (plans) $14,074 100%
Freedom Optimum $14,495 103%
Node Va $14,612 104%
Node Wellcare Mcr Adv $14,755 105%
Simply Healthcare $14,776 105%
Node Us Dept Of Labor $20,777 147%
Florida State Auto Insurance $28,651 203%
Ambetter / Centene $36,530 259%
Cigna $37,603 266%
Occunet $42,977 304%
Community Health Partners $58,297 413%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6101 Pine Ridge Road, Naples, FL 34119
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals