CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Texas Orthopedic Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $14,166
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Texas Orthopedic Hospital is $14,166. 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 1.00x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,166

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: $14,166 (100%)
Ins. Median: $14,166 (100% 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%
Aetna $1,779 - $4,272 13%
Coventry National First Health $1,941 - $2,855 14%
Oscar $2,131 - $15,105 15%
Curative Administrators $2,717 - $31,873 19%
United $3,048 - $13,764 22%
Evry Health $3,241 - $28,941 23%
Humana $13,458 - $28,496 95%
Cigna $13,750 - $35,342 97%
Wellmed $13,750 97%
Amerigroup $13,889 98%
Kelsey Seybold $13,889 98%
Texas Healthcare Foundation $13,889 98%
Triwest Healthcare Alliance $13,889 98%
Van Lang Ipa $14,028 99%
Devoted Health $14,166 100%
Integranet Amerigroup Ipa $14,166 100%
Provider Partners Health Plan Of Texas $14,166 100%
American Health Plan $14,583 103%
Procare Advantage $14,583 103%
Superior Health Plan $14,583 103%
Texas Independent Health Plan $14,722 104%
Wellcare $14,722 104%
Shared Health $14,861 105%
Universal Healthcare Group $15,000 106%
Molina $15,139 107%
Verda Health Plan $15,278 108%
Fidelis Securecare Of Tx $15,555 110%
Averde Health $17,482 124%
Imagine Health $19,272 137%
Corvel Corporation $19,662 139%
Community Health Choice $20,139 143%
Omni Healthcare $20,854 148%
Superior $21,527 152%
Healthcare Highways $23,634 167%
Molina Healthcare $28,912 205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals