CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: St John's Episcopal Hospital at South Shore

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $26,493
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.88x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at St John's Episcopal Hospital at South Shore is $26,493. 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 1.88x the Medicare baseline. Located in 327 Beach 19Th Street, Far Rockaway, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,493

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: $26,493 (188%)
Ins. Median: $26,493 (188% 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
UnitedHealthcare $21,142 - $26,493 150%
Aetna $24,782 - $26,493 176%
Vns $25,169 - $26,493 178%
Blue Cross Blue Shield $26,388 - $34,965 187%
Centerlight $26,493 188%
Centers Plan For Healthy Living $26,493 188%
Elderplan $26,493 188%
Emblem Health $26,493 - $46,804 188%
Fidelis $26,493 188%
Hamaspik $26,493 188%
Humana $26,493 188%
Longevity $26,493 188%
Lucida $26,493 188%
Metroplus $26,493 188%
Village Care Max $26,493 188%
Wellcare $26,493 188%
1199 National Benefit Fund $26,553 188%
Cigna $26,759 190%
Molina $29,143 206%
Magnacare $35,253 250%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 327 Beach 19Th Street, Far Rockaway, NY 11691
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals