CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Medical City Plano

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $16,533
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Medical City Plano is $16,533. 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 1.17x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,533

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: $16,533 (117%)
Ins. Median: $16,533 (117% 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
Oscar $1,575 - $15,771 11%
Blue Cross Blue Shield $2,017 - $30,837 14%
Aetna $2,599 - $15,998 18%
Curative Administrators $2,717 - $31,873 19%
United $3,009 - $15,852 21%
Multiplan Phcs $8,513 60%
Humana $15,884 - $57,267 113%
Wellmed $16,160 114%
Amerigroup $16,209 115%
Integranet $16,209 115%
Triwest Veterans $16,209 115%
Wellcare $16,209 115%
Care N Care $16,371 116%
Cigna $16,533 - $63,504 117%
Devoted Health $16,533 117%
Mutual Of Omaha $16,533 117%
Provider Partners Health Plan $16,533 117%
Texas Independent Health Plan $16,533 117%
American Health Plan Of Texas, Inc. $17,019 121%
Procare Advantge $17,019 121%
Superior Health Plan $17,019 121%
Imperial Insurance Company $17,181 122%
Universal Healthcare Group $17,505 124%
Molina $17,667 125%
Verda Health Plan $17,829 126%
Bravo Health $17,992 127%
Fidelis Securecare $18,316 130%
Usa Managed Care $22,019 156%
Corvel Corporation $22,947 163%
Healthcare Highways $24,813 176%
Evry Health $27,438 194%
Superior $29,013 - $36,307 206%
Molina Healthcare $34,046 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals