CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Community Medical Center

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$24,118
about 1.7× the $14,117 Medicare rate · typically $17,787–$37,039
modeled estimate · not a bill or quote
What this hospital charges insurers
$35,969
Above the fair price
about $11,851 over the fair price · 2.5× Medicare
Medicare pays $14,117 Fair price $24,118 This hospital $35,969 Cash price $2,426

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

Highest price of the 9 NJ hospitals we have prices for — worth calling around.

Cheapest $15,248 Priciest $35,969

Black dot = this hospital, among the 9 NJ hospitals with a price for this procedure. Full list below.

A fair price for a Sepsis treatment (inpatient stay) is about $24,118 (about 1.7× the $14,117 Medicare rate). Community Medical Center charges insurers about $35,969, or about $2,426 in cash — above the fair price. Located in Toms River, NJ.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $24,118. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $17,484 - $52,366 124%
Blue Cross Blue Shieldmajor $1,885 - $43,968 13%
Aetnamajor $17,141 - $47,294 121%
Cignamajor $35,689 - $47,763 253%
Humanamajor $17,141 121%
AmeriHealth $41,544 - $51,922 294%
Clover Health $17,141 121%
Fidelis Care $17,141 121%
WellCare $34,110 242%
+ 2 smaller / regional plans $5,673 - $27,042

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 99 Rt 37 West, Toms River, NJ 08755
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals