CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Ascension St Vincent's Clay County

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $14,512
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Ascension St Vincent's Clay County is $14,512. 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 1.03x the Medicare baseline. Located in 1670 St Vincents Way, Middleburg, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,512

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: $14,512 (103%)
Ins. Median: $14,512 (103% 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
Blue Cross Blue Shield $1,947 - $25,295 14%
Coventry Hmo $8,850 63%
Medicaid / KanCare $9,836 70%
North Florida Surgeons $10,000 71%
Humana $11,261 - $16,012 80%
Bc Advantage Mcr Replacement $11,609 82%
Coventry Mcr Replacement Hmo $11,609 82%
Medicare (plans) $11,609 - $11,842 82%
Research Study Encore Borland-Groover $11,609 82%
Veterans Administration $11,609 82%
Wellcare $11,609 82%
UnitedHealthcare $11,726 - $19,683 83%
Careplus Mcr Replacement $11,842 84%
Cigna $11,842 - $23,700 84%
Aetna $11,958 - $23,799 85%
Inmate Health Care $14,512 103%
Avmed Empower $14,888 105%
Bright Health $15,673 111%
Smarthealth $16,253 115%
Oscar Health Plan $18,575 132%
Northwell Direct $20,000 142%
Employer Direct Healthcare $20,316 144%
90 Degree Benefits $20,897 148%
Avmed Exchange $20,897 148%
Molina Exchange $21,477 152%
Ambetter / Centene $22,058 156%
Occunet $26,121 185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1670 St Vincents Way, Middleburg, FL 32068
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals