CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Medical City Fort Worth

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 871
Insurance Median: $17,429
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Medical City Fort Worth is $17,429. 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 1.23x the Medicare baseline. Located in 900 Eighth Avenue, Fort Worth, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,429

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: $17,429 (123%)

Ins. Median: $17,429 (123% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$2,313 - $16,865	16%
Curative Administrators	$2,717 - $31,873	19%
United	$2,780 - $16,712	20%
Multiplan Phcs	$8,513	60%
American Hospice	$16,233	115%
Humana	$16,746 - $57,267	119%
Wellmed	$17,036	121%
Amerigroup	$17,087	121%
Integranet	$17,087	121%
Triwest	$17,087	121%
Wellcare	$17,087	121%
Care N Care	$17,258	122%
Cigna	$17,429 - $63,504	123%
Devoted Health	$17,429	123%
Mutual Of Omaha	$17,429	123%
Provider Partners Health Plan	$17,429	123%
Texas Independent Health Plan	$17,429	123%
American Health Plan Of Texas, Inc.	$17,942	127%
Procare Advantge	$17,942	127%
Superior Health Plan	$17,942	127%
Imperial Insurance Company	$18,113	128%
Universal Healthcare Group	$18,454	131%
Molina	$18,625	132%
Verda Health Plan	$18,796	133%
Bravo Health	$18,967	134%
Fidelis Securecare	$19,309	137%
Usa Managed Care	$23,213	164%
Corvel Corporation	$24,191	171%
Healthcare Highways	$24,813	176%
Evry Health	$27,438	194%
Superior	$30,586 - $38,276	217%
Molina Healthcare	$34,837	247%
UnitedHealthcare	$42,000	298%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 871.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Medical City Fort Worth is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 871.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.