CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: HCA Houston Healthcare West

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $20,542
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.46x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at HCA Houston Healthcare West is $20,542. 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 1.46x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$20,542

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: $20,542 (146%)
Ins. Median: $20,542 (146% 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 $1,760 - $30,800 12%
Coventry National First Health $1,941 - $2,855 14%
Oscar $2,131 - $20,131 15%
Aetna $2,669 - $20,275 19%
Curative Administrators $2,717 - $31,873 19%
Evry Health $3,241 - $28,941 23%
United $3,293 - $20,357 23%
Cigna $16,678 - $40,322 118%
Averde Health $17,482 124%
Imagine Health $19,272 137%
Humana $19,905 - $28,496 141%
Wellmed $20,377 144%
Amerigroup $20,542 146%
Chc Harris Health $20,542 146%
Integranet Amerigroup Ipa $20,542 146%
Kelsey Seybold $20,542 146%
Texas Healthcare Foundation $20,542 146%
Triwest Healthcare Alliance $20,542 146%
Texas Independent Health Plan $20,747 147%
Van Lang Ipa $20,747 147%
Wellcare $20,747 147%
Devoted Health $20,953 148%
Provider Partners Health Plan Of Texas $20,953 148%
American Health Plan $21,569 153%
Procare Advantage $21,569 153%
Superior Health Plan $21,569 153%
Shared Health $21,980 156%
Universal Healthcare Group $22,185 157%
Fidelis Securecare Of Tx $22,390 159%
Molina $22,390 159%
Verda Health Plan $22,596 160%
Healthcare Highways $23,634 167%
Corvel Corporation $29,081 206%
Community Health Choice $29,786 211%
Molina Healthcare $30,293 215%
Omni Healthcare $30,843 218%
Superior $31,840 226%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals