CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Palisades Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $26,951
Cash Discount Price: $23,610
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Palisades Medical Center is $26,951. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,610. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.91x the Medicare baseline. Located in 7600 River Rd, North Bergen, NJ.

Cash / Self-Pay

$23,610

Average discount available for prompt cash payment at this facility.

Insurance Median

$26,951

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%)

Cash / Self-Pay: $23,610 (167%)

Insurance Median: $26,951 (191%)

Cash: $23,610 (167% of Medicare)

Ins. Median: $26,951 (191% 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
Horizon	$8,479 - $68,626	60%
Amerihealth	$18,907	134%
Vaccn	$23,610	167%
Aetna	$24,280 - $48,878	172%
Amerigroup	$24,280	172%
Blue Cross Blue Shield	$24,280	172%
Wellcare	$24,280	172%
Clover	$26,708	189%
Seoul Medical Group	$27,194	193%
Karna	$34,049	241%
Cigna	$44,840 - $50,675	318%
Oxford	$62,193	441%
Brighton Health Plan	$63,123	447%
UnitedHealthcare	$74,136	525%

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 $23,610.
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 Palisades Medical Center 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.