CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Jacobi Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $31,329
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.22x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Jacobi Medical Center is $31,329. 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 2.22x the Medicare baseline. Located in 1400 Pelham Parkway South, Bronx, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$31,329

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: $31,329 (222%)

Ins. Median: $31,329 (222% 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 222% of the Medicare baseline (a markup of 122%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Oscar	$17,861	127%
Local 1199	$24,632	174%
Healthfirst	$29,136	206%
Centerlight	$30,702	217%
Aetna	$31,329 - $43,720	222%
Blue Cross Blue Shield	$31,329	222%
Elderplan	$31,329	222%
Emblem	$31,329 - $37,521	222%
Fidelis	$31,329 - $44,487	222%
Hamaspik	$31,329	222%
Oxford	$31,329 - $52,007	222%
Senior Whole Health	$31,329 - $32,135	222%
Vaccn	$31,329	222%
Vnsny	$31,329	222%
Wellcare	$31,799	225%
Metroplus	$32,269	229%
Centers Plan For Healthy Living	$32,582	231%
Villagecare Max	$35,401	251%
Cigna	$36,782	261%
Multiplan	$50,946	361%
United	$55,500 - $64,247	393%

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 Jacobi 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.