CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Ascension Seton Southwest

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $12,170
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.86x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Ascension Seton Southwest is $12,170. 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 0.86x the Medicare baseline. Located in 7900 Fm 1826, Austin, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,170

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: $12,170 (86%)
Ins. Median: $12,170 (86% 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
Cshcn Cidc $6,150 44%
Whole Foods $9,063 64%
Oscar Health Exchange $9,379 66%
Tricare $10,507 - $12,170 74%
Aarp Mc Wellmed $11,927 84%
Sendero Chap $12,049 85%
Addr Cancer Together $12,170 86%
Aetna $12,170 86%
Covid Hrsa $12,170 86%
Devoted Health Mcr Replacement $12,170 86%
Humana $12,170 86%
Medicare (plans) $12,170 86%
Research Study $12,170 86%
Smarthealth $12,170 86%
Superior Allwell $12,170 86%
Wellcare Med Advantage $12,170 86%
UnitedHealthcare $12,414 88%
Connected Senior Care $12,536 89%
Pphp Mcr Advantage $12,779 91%
Tx Independence Hp $12,779 91%
Occunet $17,039 121%
Sendero Idealcare $21,298 151%
Ambetter / Centene $21,907 155%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7900 Fm 1826, Austin, TX 78737
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals