CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Mercy Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $18,574
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Mercy Medical Center is $18,574. 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 1.32x the Medicare baseline. Located in 1000 North Village Avenue, Rockville Centre, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,574

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: $18,574 (132%)
Ins. Median: $18,574 (132% 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 $6,454 - $9,258 46%
Us Family Health Plan $13,333 94%
Blue Cross Blue Shield $17,770 - $47,732 126%
Emblem Health $17,770 - $44,889 126%
Centerlight Healthcare $17,846 126%
Beacon Health Options $18,210 - $25,494 129%
Beacon Health Strategies $18,210 - $25,494 129%
Centers Plan For Healthy Living $18,210 129%
Elderplan Inc. $18,210 129%
Fidelis Care New York $18,210 129%
Healthspring $18,210 129%
Independent Health $18,210 129%
Liberty Health $18,210 129%
Longevity Health Plan $18,210 129%
Medicare (plans) $18,210 - $19,121 129%
Mvp Health Plans $18,210 - $35,377 129%
Orthonet - Uniformed Services Family Health Plan $18,210 129%
Pmc $18,210 129%
Senior Whole Health $18,210 129%
Tricare $18,210 129%
UnitedHealthcare $18,210 - $47,732 129%
Universal Healthcare $18,210 129%
Veterans Affairs $18,210 129%
Zadroga $18,210 129%
Aetna $18,257 - $40,137 129%
Health Plus $18,257 129%
Health First $18,392 - $40,973 130%
Humana $18,574 132%
Agewell New York $18,848 134%
Wellcare Health Plan Inc $18,939 134%
Partners Health Plan $19,121 135%
Centivo $29,388 - $35,377 208%
Apwu $35,377 251%
Cigna $35,377 251%
Daniel H Cook $35,377 251%
Nalc $35,377 251%
Samba $35,377 251%
Local 1199 $36,532 259%
Mail Handlers Benefit Plan $40,137 284%
Meritain Health $40,137 284%
Nippon Life Insurance Company Of America $40,137 284%
Salvation Army $40,137 284%
American Plan Administrators $44,889 318%
Amerihealth Administrators $44,889 318%
Benefit Services $44,889 318%
Ghi Cbp Ny City Employee Alternate $44,889 318%
International Benefit Administrator $44,889 318%
Ultra Benefits Inc. $44,889 318%
Surest $45,472 322%
Self Pay $47,732 338%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 North Village Avenue, Rockville Centre, NY 11571
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals