CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: HCA Houston Healthcare Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $16,257
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at HCA Houston Healthcare Medical Center is $16,257. 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 1.15x the Medicare baseline. Located in 1313 Hermann Dr, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,257

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: $16,257 (115%)
Ins. Median: $16,257 (115% 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 - $15,697 15%
Aetna $2,669 - $5,299 19%
Curative Administrators $2,717 - $31,873 19%
Evry Health $3,241 - $28,941 23%
United $3,293 - $15,873 23%
Humana $15,521 - $28,496 110%
Cigna $15,857 - $40,322 112%
Wellmed $15,857 112%
Triwest Healthcare Alliance $16,017 113%
Van Lang Ipa $16,177 115%
Devoted Health $16,337 116%
Integranet Amerigroup Ipa $16,337 116%
Provider Partners Health Plan Of Texas $16,337 116%
Texas Independent Health Plan $16,658 118%
Wellcare $16,658 118%
American Health Plan $16,818 119%
Procare Advantage $16,818 119%
Superior Health Plan $16,818 119%
Shared Health $17,138 121%
Molina $17,459 124%
Verda Health Plan $17,619 125%
Community Health Choice $23,225 165%
Healthcare Highways $23,634 167%
Superior $24,826 176%
Molina Healthcare $28,625 203%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1313 Hermann Dr, Houston, TX 77004
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals