CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: HCA Houston Healthcare Southeast

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $22,064
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at HCA Houston Healthcare Southeast is $22,064. 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 1.56x the Medicare baseline. Located in 4000 Spencer Hwy, Pasadena, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$22,064

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: $22,064 (156%)
Ins. Median: $22,064 (156% 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
Multiplan $1,540 - $17,667 11%
Blue Cross Blue Shield $1,760 - $30,800 12%
Coventry National First Health $1,941 - $2,855 14%
Oscar $2,131 - $21,623 15%
Aetna $2,669 - $21,777 19%
Curative Administrators $2,717 - $31,873 19%
Evry Health $3,241 - $28,941 23%
United $3,293 - $21,865 23%
Averde Health $17,482 124%
Imagine Health $19,272 137%
Humana $21,380 - $28,496 151%
Cigna $21,843 - $39,629 155%
Wellmed $21,843 155%
Amerigroup $22,064 156%
Chc Harris Health $22,064 156%
Integranet Amerigroup Ipa $22,064 156%
Kelsey Seybold $22,064 156%
Texas Healthcare Foundation $22,064 156%
Texas Independent Health Plan $22,064 156%
Triwest Healthcare Alliance $22,064 156%
Wellcare $22,064 156%
Van Lang Ipa $22,284 158%
Devoted Health $22,505 159%
Provider Partners Health Plan Of Texas $22,505 159%
American Health Plan $23,167 164%
Procare Advantage $23,167 164%
Superior Health Plan $23,167 164%
Shared Health $23,608 167%
Healthcare Highways $23,634 167%
Universal Healthcare Group $23,829 169%
Fidelis Securecare Of Tx $24,050 170%
Molina $24,050 170%
Verda Health Plan $24,270 172%
Kindred Hospital $25,373 180%
Molina Healthcare $29,874 212%
Corvel Corporation $31,236 221%
Community Health Choice $31,992 227%
Omni Healthcare $33,129 235%
Superior $34,199 242%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4000 Spencer Hwy, Pasadena, TX 77504
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals