CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Thomas Jefferson University Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $23,585
  • Cash Discount Price: $23,261
  • vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Thomas Jefferson University Hospital is $23,585. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,261. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.67x the Medicare baseline. Located in 111 South 11Th Street, Philadelphia, PA.
Cash / Self-Pay
$23,261

Average discount available for prompt cash payment at this facility.

Insurance Median
$23,585

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%)
Cash / Self-Pay: $23,261 (165%)
Insurance Median: $23,585 (167%)
Cash: $23,261 (165% of Medicare)
Ins. Median: $23,585 (167% 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
Medicare (plans) $15,431 - $23,381 109%
Aetna $19,205 - $57,119 136%
Jefferson Health Plan Aca Qhp Exchange $19,507 138%
Inspira Life $20,332 144%
Point Of Comfort Refugee Resettlement $20,332 144%
St Agnes $20,332 144%
Tricare $20,332 144%
UnitedHealthcare $20,332 - $21,958 144%
Humana $20,738 147%
Innovage $20,738 147%
Cigna $21,145 - $55,859 150%
Keystone First Vip Choice $21,145 150%
Ambetter / Centene $21,333 151%
Devoted Health Participation $21,348 151%
Provider Partners Health Plan $21,755 154%
Allwell Pa Health_Wellness Ma $22,365 158%
Highmark Wholecare Gateway $22,365 158%
Perennial $23,585 167%
Ibc Employee Benefit $25,414 180%
Ibc Main Line Health $25,414 180%
Naphcare $25,600 - $32,530 181%
Ibc $31,223 - $59,560 221%
Blue Cross Blue Shield $31,666 - $48,030 224%
Highmark $35,663 - $44,189 253%
Qualcare Jcc $37,517 - $69,911 266%
Upmc Commercial $55,859 396%
Geisinger Health Plan $58,075 411%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 111 South 11Th Street, Philadelphia, PA 19107
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals