CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Medical City North Hills

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $18,250
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Medical City North Hills is $18,250. 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 1.29x the Medicare baseline. Located in 4401 Booth Calloway Road, North Richland Hills, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,250

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: $18,250 (129%)
Ins. Median: $18,250 (129% 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.

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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 $1,575 - $15,771 11%
United $2,231 - $17,328 16%
Aetna $2,433 - $17,488 17%
Curative Administrators $2,717 - $31,873 19%
Blue Cross Blue Shield $4,136 - $30,837 29%
Multiplan Phcs $9,024 64%
Humana $17,364 - $57,267 123%
Wellmed $17,665 125%
Amerigroup $17,718 126%
Integranet $17,718 126%
Triwest Veterans $17,718 126%
Care N Care $17,895 127%
Cigna $18,072 - $58,393 128%
Devoted Health $18,072 128%
Provider Partners Health Plan $18,072 128%
Texas Independent Health Plan $18,072 128%
Wellcare $18,072 128%
Mutual Of Omaha $18,427 131%
American Health Plan Of Texas, Inc. $18,604 132%
Procare Advantge $18,604 132%
Superior Health Plan $18,604 132%
Imperial Insurance Company $18,781 133%
Universal Healthcare Group $19,135 136%
Molina $19,313 137%
Verda Health Plan $19,490 138%
Bravo Health $19,667 139%
Fidelis Securecare $20,021 142%
Usa Managed Care $24,070 171%
Corvel Corporation $25,083 178%
Healthcare Highways $25,806 183%
Evry Health $27,438 194%
Superior $31,715 - $39,688 225%
Molina Healthcare $33,498 237%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4401 Booth Calloway Road, North Richland Hills, TX 76180
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals