CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Bellevue Hospital Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $42,396
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.00x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Bellevue Hospital Center is $42,396. 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 3.00x the Medicare baseline. Located in 462 First Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$42,396

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: $42,396 (300%)

Ins. Median: $42,396 (300% 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 300% of the Medicare baseline (a markup of 200%). 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%
Oxford	$36,332 - $42,396	257%
Cigna	$36,782	261%
Emblem	$37,521 - $42,396	266%
Healthfirst	$39,429	279%
Centerlight	$41,548	294%
United	$41,548 - $53,548	294%
Aetna	$41,907 - $42,396	297%
Blue Cross Blue Shield	$42,396	300%
Elderplan	$42,396	300%
Hamaspik	$42,396	300%
Senior Whole Health	$42,396 - $43,840	300%
Vaccn	$42,396	300%
Vnsny	$42,396	300%
Wellcare	$43,032	305%
Metroplus	$43,668	309%
Centers Plan For Healthy Living	$44,092	312%
Fidelis	$46,212 - $60,203	327%
Villagecare Max	$47,908	339%
Multiplan	$52,737	374%

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 Bellevue Hospital 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.