CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: St Francis Hospital - the Heart Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $17,628
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at St Francis Hospital - the Heart Center is $17,628. 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 1.25x the Medicare baseline. Located in 100 Port Washington Boulevard, Roslyn, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,628

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: $17,628 (125%)
Ins. Median: $17,628 (125% 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
Brighton $9,878 - $12,625 70%
Us Family Health Plan $13,295 94%
Blue Cross Blue Shield $16,691 - $61,086 118%
Centerlight Healthcare $16,691 118%
Centers Plan For Healthy Living $17,032 121%
Elderplan Inc. $17,032 121%
Emblem Health $17,032 - $73,141 121%
Fidelis Care New York $17,032 121%
Healthspring $17,032 121%
Independent Health $17,032 121%
Liberty Health $17,032 121%
Longevity Health Plan $17,032 121%
Medicare (plans) $17,032 - $17,883 121%
Mvp Health Plans $17,032 - $50,920 121%
Orthonet - Uniformed Services Family Health Plan $17,032 121%
Pmc $17,032 121%
Senior Whole Health $17,032 121%
Tricare $17,032 121%
UnitedHealthcare $17,032 - $61,086 121%
Universal Healthcare $17,032 121%
Veterans Affairs $17,032 121%
Zadroga $17,032 121%
Health First $17,202 - $38,321 122%
Aetna $17,299 - $61,431 123%
Health Plus $17,299 123%
Humana $17,372 123%
Agewell New York $17,628 125%
Wellcare Health Plan Inc $17,713 125%
Partners Health Plan $17,883 127%
Local 1199 $34,659 246%
Centivo $43,023 - $50,920 305%
Apwu $50,920 361%
Cigna $50,920 361%
Daniel H Cook $50,920 361%
Nalc $50,920 361%
Samba $50,920 361%
Surest $60,664 430%
Self Pay $61,086 433%
Mail Handlers Benefit Plan $61,431 435%
Meritain Health $61,431 435%
Nippon Life Insurance Company Of America $61,431 435%
Salvation Army $61,431 435%
American Plan Administrators $73,141 518%
Amerihealth Administrators $73,141 518%
Benefit Services $73,141 518%
Ghi Cbp Ny City Employee Alternate $73,141 518%
International Benefit Administrator $73,141 518%
Ultra Benefits Inc. $73,141 518%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Port Washington Boulevard, Roslyn, NY 11576
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals