CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: St David's Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $15,643
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at St David's Medical Center is $15,643. 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 1.11x the Medicare baseline. Located in 919 E 32Nd St, Austin, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,643

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: $15,643 (111%)
Ins. Median: $15,643 (111% 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 $1,633 - $12,300 12%
Blue Cross Blue Shield $2,007 - $30,681 14%
First Health $2,308 16%
Nomi Health $2,328 - $28,975 16%
Curative Administrators $2,717 - $31,873 19%
United $3,085 - $15,503 22%
Aetna $3,463 - $16,738 25%
Harbor Health Team $3,700 - $37,800 26%
Evry Health $4,052 - $28,941 29%
Cigna $4,649 - $16,113 33%
Altus Hospice (Hospice Of The Hills) $14,079 100%
Cella Bella Hospice $14,079 100%
Compassionate Care Mcr $14,079 100%
Heart To Heart Hospice $14,079 100%
Hospice Austin $14,079 100%
Hospice Compassus $14,079 100%
Silverado Hospice $14,079 100%
St David’S Hospice $14,079 100%
Moda $14,483 103%
Wellmed $15,440 109%
Angel Heart Hospice $15,643 111%
Aseracare Hospice $15,643 111%
Girling Hospice $15,643 111%
Lighthouse Hospice, Llc. $15,643 111%
Odyssey Hospice $15,643 111%
Southern Care Hospice $15,643 111%
Texas Home Health Hospice $15,643 111%
Triwest Healthcare Alliance $15,643 111%
Triwest Veterans $15,643 111%
Vistacare Family Hospice $15,643 111%
Wesleyan Homes, Inc. $15,643 111%
Devoted Health $15,956 113%
Humana $15,956 - $16,738 113%
Provider Partners Health Plan $15,956 113%
Texas Independent Health Plan $15,956 - $17,990 113%
Wellcare $15,956 - $17,990 113%
American Health Plan Of Texas $16,426 - $17,208 116%
Superior Health Plan $16,426 - $25,029 116%
Universal Health $16,426 116%
Imperial Insurance $16,582 117%
Shared Health $16,738 119%
Molina Healthcare $17,051 121%
Pyramid Life $17,208 122%
Austin Fc $19,554 139%
Sendero $21,118 - $26,750 150%
Corvel Corporation $22,146 157%
Naphcare $24,247 172%
Seven Corners $24,247 172%
Healthcare Highways $24,390 - $24,885 173%
Moda Health $26,292 - $26,818 186%
Covenant Management Systems $32,117 228%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 919 E 32Nd St, Austin, TX 78705
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals