CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: St Charles Hospital

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$25,593

about 1.8× the $14,117 Medicare rate · typically $18,189–$40,743

modeled estimate · not a bill or quote

What this hospital charges insurers

$23,775

About the fair price

about $1,818 under the fair price · 1.7× Medicare

Medicare pays $14,117 Fair price $25,593 This hospital $23,775

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

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

Cheapest $8,042 Priciest $23,775

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

A fair price for a Sepsis treatment (inpatient stay) is about $25,593 (about 1.8× the $14,117 Medicare rate). St Charles Hospital charges insurers about $23,775 — about the fair price. Located in Port Jefferson, NY.

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	$18,288 - $45,542	130%
Blue Cross Blue Shieldmajor	$17,923 - $45,542	127%
Aetnamajor	$18,442 - $40,863	131%
Cignamajor	$35,377	251%
Humanamajor	$18,654	132%
AmeriHealth	$44,889	318%
Cigna HealthSpring	$18,288	130%
Fidelis Care	$18,288	130%
Independent Health	$18,288	130%
MVP Health Care	$18,288 - $35,377	130%
WellCare	$19,020	135%
+ 32 smaller / regional plans	$6,454 - $45,472

Government programs also on file: Medicare, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 871.

Insurance Before you use insurance

Call your insurance company to confirm St Charles Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 871.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

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

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Charles Hospital

Compare: Sepsis treatment (inpatient stay) at other NY hospitals

United Memorial Medical Center · Batavia $8,042
Kenmore Mercy Hospital · Kenmore $11,437
Mercy Hospital of Buffalo · Buffalo $11,437
Montefiore St Luke's Cornwall · Newburgh $16,782
Arnot Ogden Medical Center · Elmira $16,884
Montefiore Mount Vernon Hospital · Mount Vernon $17,174
Montefiore New Rochelle Hospital · New Rochelle $17,253
Bertrand Chaffee Hospital · Springville $17,440

Insurance negotiated median for the same procedure, sorted lowest first.