CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Sacred Heart Hospital on the Emerald Coast

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $11,581
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Sacred Heart Hospital on the Emerald Coast is $11,581. 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 0.82x the Medicare baseline. Located in 7800 Us Hwy 98 W, Miramar Beach, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$11,581

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: $11,581 (82%)

Ins. Median: $11,581 (82% 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
Blue Cross Blue Shield	$2,105 - $17,596	15%
Aarp Mcr Hmo	$11,467	81%
Blue Mcr Replacement	$11,467	81%
Facility Billing - Op	$11,467	81%
Medicare (plans)	$11,467	81%
Triwest	$11,467	81%
Wellcare	$11,467	81%
Cigna	$11,580	82%
Smarthealth	$11,581	82%
UnitedHealthcare	$11,581 - $17,296	82%
Healthspring Mcr Replacement	$11,696	83%
Aetna	$11,811 - $20,475	84%
Humana	$11,811	84%
Oscar Health Plan	$18,347	130%
Ambetter / Centene	$18,920	134%
Occunet	$25,800	183%

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 Sacred Heart Hospital on the Emerald Coast 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.