CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Oakbend Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $14,742
Cash Discount Price: $11,333
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Oakbend Medical Center is $14,742. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,333. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.04x the Medicare baseline. Located in 1705 Jackson St, Richmond, TX.

Cash / Self-Pay

$11,333

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,742

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: $11,333 (80%)

Insurance Median: $14,742 (104%)

Cash: $11,333 (80% of Medicare)

Ins. Median: $14,742 (104% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$10,140 - $14,742	72%
Humana	$11,706 - $13,321	83%
Ambetter / Centene	$14,742 - $18,011	104%
Friday Health Plan Mcr	$14,742	104%
Medicare (plans)	$14,742	104%
UnitedHealthcare	$14,996	106%
Wellcare Mcare-All Plans	$15,479	110%
Cigna	$17,482	124%
Friday Health Plan-All Other Plans	$18,427	131%
Medicaid / KanCare	$19,709	140%
Community Health Choice-All Plans	$22,439	159%
Oscar - All Plans	$24,139	171%
Aetna	$29,731	211%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $11,333.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 871.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Oakbend Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 871.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.