CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Freestone Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $13,241
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Freestone Medical Center is $13,241. 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 0.94x the Medicare baseline. Located in 125 Newman St, Fairfield, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$13,241

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: $13,241 (94%)
Ins. Median: $13,241 (94% 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
Scott & White Commercial $12,153 86%
Scott & White Employees $12,153 86%
Aarp Mcare /Wellmed $13,241 94%
Aetna $13,241 94%
Allwell Superior Hlth $13,241 94%
Ambetter / Centene $13,241 94%
Care Improvement Plus $13,241 94%
Champva $13,241 94%
Humana $13,241 94%
Medicare (plans) $13,241 94%
Misc Mcare Replacement $13,241 94%
Pphp Prov Part Hlth Plan $13,241 94%
Scott & White Senior Care $13,241 94%
Superior Hlth Mcare Repl $13,241 94%
Tricare $13,241 94%
Triwest $13,241 94%
Triwest Va Ccn Claims $13,241 94%
UnitedHealthcare $13,241 - $17,867 94%
Utmb Corr Mgd Care $13,241 94%
Va Vha Office Comm Care $13,241 94%
Veteran'S Administration $13,241 94%
Wellmed $13,241 94%
Workers Compensation $13,241 94%
Aarp $17,867 127%
Apwu $17,867 127%
Fringe Benefits $17,867 127%
Geha $17,867 127%
Uhcss $17,867 127%
Blue Cross Blue Shield $18,805 - $21,496 133%
Cigna $22,654 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Newman St, Fairfield, TX 75840
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals