CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Jamaica Hospital Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $28,402
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.01x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Jamaica Hospital Medical Center is $28,402. 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 2.01x the Medicare baseline. Located in 89Th Avenue and Van Wyck Expressway, Jamaica, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$28,402

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: $28,402 (201%)
Ins. Median: $28,402 (201% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 201% of the Medicare baseline (a markup of 101%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Hotel Trades Council $1,912 14%
World Trade Center Program $2,914 21%
Healthfirst $13,335 - $28,073 94%
Aetna $28,073 199%
Beacon Health Strategies $28,073 199%
Centerlight Healthcare $28,073 199%
Elderplan $28,073 199%
Empire $28,073 199%
Fidelis $28,073 199%
Ghi $28,073 - $43,415 199%
Hip $28,073 - $35,775 199%
Metroplus $28,073 - $30,880 199%
UnitedHealthcare $28,073 - $30,968 199%
Wellcare Of Ny $28,073 199%
Emblemhealth $28,170 200%
Vns $28,635 203%
Empire - Healthplus D $28,915 205%
Villagecaremax $29,477 209%
Humana $29,898 212%
Hamaspik Choice $30,880 219%
Senior Whole Health $30,880 219%
Centers Plan For Healthy Living $31,442 223%
1999 National Benefit Fund $32,047 227%
Magnacare $32,284 229%
Cigna $34,884 247%
Centivo $36,726 260%
Oscar $37,594 266%
Create Health Plan $46,517 330%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 89Th Avenue and Van Wyck Expressway, Jamaica, NY 11418
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals