CMS Price Transparency Data
Sepsis treatment (inpatient stay)
Facility: Methodist Southlake Medical Center
Billing Code: 871 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 871
- Insurance Median: $18,434
- Cash Discount Price: $39,454
- vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Methodist Southlake Medical Center is $18,434. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39,454. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.31x the Medicare baseline. Located in 421 E State Highway 114, Southlake, TX.
Cash / Self-Pay
$39,454
Average discount available for prompt cash payment at this facility.
Insurance Median
$18,434
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: $39,454 (279%)
Insurance Median: $18,434 (131%)
Cash: $39,454 (279% of Medicare)
Ins. Median: $18,434 (131% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bind Benefits Inc [1004] | $6,019 | 43% |
| Definity Health [3006] | $6,019 | 43% |
| Freedom Life Insurance Company [2029] | $6,019 | 43% |
| Geha Federal [3066] | $6,019 | 43% |
| Tml Intergovernmental Employee Benefits [3050] | $6,019 | 43% |
| UnitedHealthcare | $6,019 - $14,747 | 43% |
| Aetna | $13,913 - $33,019 | 99% |
| Blue Cross Blue Shield | $13,913 - $36,073 | 99% |
| Medicare (plans) | $13,913 - $14,886 | 99% |
| Ust Health Proof [1005] | $13,913 | 99% |
| Wellcare [7016] | $13,913 | 99% |
| American Health Advantage Of Texas [7099] | $14,608 | 103% |
| Cigna | $14,608 - $22,564 | 103% |
| Globalhealth [1003] | $14,608 | 103% |
| Procare Advantage [7018] | $14,608 | 103% |
| Humana | $14,747 | 104% |
| Southwestern Health Resources Swhr [7015] | $14,747 | 104% |
| Champva [1000] | $14,971 | 106% |
| Tricare | $14,971 | 106% |
| Triwest Wps [8010] | $14,971 | 106% |
| Veterans Administration [9001] | $14,971 | 106% |
| Provider Partners Health Plan [7025] | $15,304 | 108% |
| Mcs Advantage, Inc Classicare [7021] | $15,721 | 111% |
| Medical Card System [2063] | $15,721 | 111% |
| Alternative Service Concepts [8005] | $17,391 | 123% |
| Oscar Insurance Company [2057] | $19,478 | 138% |
| Department Of Labor [8004] | $19,895 | 141% |
| Generic Workers Comp Tx Non Par [9010] | $19,895 | 141% |
| Generic Workers Comp Tx Par [8002] | $19,895 | 141% |
| Generic Workers Comp Tx Par [9011] | $19,895 | 141% |
| Tristar Risk Management [8006] | $19,895 | 141% |
| Molina [3017] | $20,173 | 143% |
| Bright Healthcare [2222] | $20,294 | 144% |
| Sana Benefits [3069] | $20,869 | 148% |
| Wellpoint Marketplace Exchange [3071] | $21,564 | 153% |
| Web Tpa [3049] | $22,564 - $33,019 | 160% |
| 90 Degree Benefit [3057] | $22,956 | 163% |
| Allied National [2031] | $22,956 | 163% |
| Entrust/90 Degree [2058] | $22,956 | 163% |
| Kempton Group Administrators, Tower Extrusions [3061] | $23,310 | 165% |
| Friday Health Plan [2061] | $23,651 | 168% |
| Ambetter / Centene | $23,790 | 169% |
| Imperial Insurance Companies [3073] | $25,043 | 177% |
| Scott & White Health Plan Trs [3062] | $28,310 | 201% |
| Evry Health [1013] | $34,781 | 246% |
| Medical Cost Containment Professionals [3059] | $34,781 | 246% |
| Velocity [3070] | $34,781 | 246% |
| Dart Member Care [3039] | $37,564 | 266% |
| Healthscope Benefits [2052] | $37,564 | 266% |
| Healthscope Benefits [3063] | $37,564 | 266% |