CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Houston Methodist Sugarland Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $16,584
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Houston Methodist Sugarland Hospital is $16,584. 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 16655 Southwest Freeway, Sugar Land, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,584

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: $16,584 (117%)
Ins. Median: $16,584 (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
Blue Cross Blue Shield $15,077 - $30,165 107%
Humana $15,077 107%
Triwest Healthcare $15,077 107%
UnitedHealthcare $15,077 - $29,399 107%
Aetna $15,303 108%
Cigna $15,529 - $26,014 110%
Wellpoint $15,529 110%
Molina Healthcare $15,830 - $30,153 112%
Oscar $15,830 112%
Community Health Choice $16,132 - $28,646 114%
Devoted Health $16,132 - $18,846 114%
Procare Advantage $16,584 - $18,846 117%
Texas Annual Conference $24,575 - $28,646 174%
Entrust $29,714 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16655 Southwest Freeway, Sugar Land, TX 77479
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals