CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Memorial Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $20,664
  • Cash Discount Price: $16,180
  • vs. Medicare Baseline: 1.46x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Memorial Medical Center is $20,664. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,180. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.46x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$16,180

Average discount available for prompt cash payment at this facility.

Insurance Median
$20,664

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%)
Cash / Self-Pay: $16,180 (115%)
Insurance Median: $20,664 (146%)
Cash: $16,180 (115% of Medicare)
Ins. Median: $20,664 (146% 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
Humana $6,556 46%
Cigna $7,169 51%
UnitedHealthcare $7,576 - $21,034 54%
Coventry First Hlth Hmo Ppo-All Other Plans $7,800 55%
Blue Cross Blue Shield $8,145 - $9,050 58%
Prime Healthcare Services-All Plans $16,180 115%
Healthcare Highways-All Plans $17,553 124%
Capstar Health Network-All Plans $18,492 131%
Aetna $19,228 136%
Corvel Work Comp-All Plans $19,647 139%
Galaxy Health Network-All Plans $19,647 139%
Independent Med Sys Ppo-All Plans $19,647 139%
Multiplan Phcs Ppo-All Other Plans $19,647 139%
Provider Select Ppo-All Plans $19,647 139%
Three Rivers Ppo-All Plans $19,647 139%
Usa Mso - All Plans $19,647 139%
Amerigroup Mcr Adv-All Other Plans $20,664 146%
Care Improvement Plus - All Other Plans $20,664 146%
Coventry First Hlth Mcr Adv $20,664 146%
Multiplan Mcr Adv $20,664 146%
Superior Allwell Mcr Adv-All Other Plans $20,664 146%
Universal American Mcr-All Other Plans $20,664 146%
Care Improvement Plus Mcr $20,871 148%
Amerigroup Chip $21,034 149%
Amerigroup Star $21,034 149%
Amerigroup Star Kids $21,034 149%
Amerigroup Star Plus $21,034 149%
Comm Health Chip $21,034 149%
Comm Health Perinatal-All Other Plans $21,034 149%
Molina Chip/Star-All Plans $21,034 149%
Scott & White Chip/Star-All Plans $21,034 149%
Superior Chip/Star $21,034 149%
Texas Childrens Hp - All Plans $21,034 149%
Universal American Snp $21,697 154%
Comm Health Mcaid Hmo $22,086 156%
Comm Health Star $22,086 156%
Ambetter / Centene $24,797 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals