CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Methodist Richardson Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $18,434
  • Cash Discount Price: $53,804
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Methodist Richardson Medical Center is $18,434. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53,804. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.31x the Medicare baseline. Located in 2831 E President George Bush Highway, Richardson, TX.
Cash / Self-Pay
$53,804

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,434

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: $53,804 (381%)
Insurance Median: $18,434 (131%)
Cash: $53,804 (381% of Medicare)
Ins. Median: $18,434 (131% 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
Blue Cross Blue Shield $13,867 - $33,842 98%
Aetna $16,313 - $33,177 116%
Covid19 Hrsa Uninsured Testing And Treatment Fund [6005] $16,313 116%
Medicare (plans) $16,313 - $17,455 116%
UnitedHealthcare $16,313 - $17,292 116%
Ust Health Proof [1005] $16,313 116%
Wellcare [7016] $16,313 116%
American Health Advantage Of Texas [7099] $17,129 121%
Cigna $17,129 - $22,564 121%
Globalhealth [1003] $17,129 121%
Procare Advantage [7018] $17,129 121%
Humana $17,292 122%
Southwestern Health Resources Swhr [7015] $17,292 122%
Provider Partners Health Plan [7025] $17,945 127%
Mcs Advantage, Inc Classicare [7021] $18,434 131%
Medical Card System [2063] $18,434 131%
Coralvita [9216] $19,576 139%
Bright Healthcare [2222] $20,294 144%
Alternative Service Concepts [8005] $20,392 144%
90 Degree Benefit [3057] $20,480 145%
Allied National [2031] $20,480 145%
Ambetter / Centene $20,480 145%
Entrust/90 Degree [2058] $20,480 145%
Web Tpa [3049] $22,564 160%
Oscar Insurance Company [2057] $22,839 162%
Molina [3017] $23,654 168%
Sana Benefits [3069] $24,470 173%
Imperial Insurance Companies [3073] $29,364 208%
Wellpoint Marketplace Exchange [3071] $31,744 225%
Friday Health Plan [2061] $34,816 247%
Evry Health [1013] $40,783 289%
Medical Cost Containment Professionals [3059] $40,783 289%
Dart Member Care [3039] $44,046 312%
Healthscope Benefits [2052] $44,046 312%
Healthscope Benefits [3063] $44,046 312%
Velocity [3070] $51,199 363%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2831 E President George Bush Highway, Richardson, TX 75082
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals