CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Methodist Midlothian Medical Center

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $16,653
  • Cash Discount Price: $30,431
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Methodist Midlothian Medical Center is $16,653. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30,431. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 1.18x the Medicare baseline. Located in 1201 E Highway 287, Midlothian, TX.
Cash / Self-Pay
$30,431

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,653

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: $30,431 (216%)
Insurance Median: $16,653 (118%)
Cash: $30,431 (216% of Medicare)
Ins. Median: $16,653 (118% 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
UnitedHealthcare $12,187 - $14,834 86%
Ust Health Proof [1005] $12,187 86%
Aetna $13,994 - $22,671 99%
Blue Cross Blue Shield $13,994 - $14,834 99%
Covid19 Hrsa Uninsured Testing And Treatment Fund [6005] $13,994 99%
Medicare (plans) $13,994 - $14,974 99%
Wellcare [7016] $13,994 99%
American Health Advantage Of Texas [7099] $14,694 104%
Cigna $14,694 - $22,564 104%
Globalhealth [1003] $14,694 104%
Procare Advantage [7018] $14,694 104%
Humana $14,834 105%
Southwestern Health Resources Swhr [7015] $14,834 105%
Provider Partners Health Plan [7025] $15,394 109%
Mcs Advantage, Inc Classicare [7021] $15,814 112%
Medical Card System [2063] $15,814 112%
Alternative Service Concepts [8005] $17,493 124%
Oscar Insurance Company [2057] $19,592 139%
Department Of Labor [8004] $20,012 142%
Generic Workers Comp Tx Non Par [9010] $20,012 142%
Generic Workers Comp Tx Par [8002] $20,012 142%
Generic Workers Comp Tx Par [9011] $20,012 142%
Tristar Risk Management [8006] $20,012 142%
Molina [3017] $20,292 144%
Bright Healthcare [2222] $20,294 144%
Sana Benefits [3069] $20,992 149%
Wellpoint Marketplace Exchange [3071] $21,691 154%
Web Tpa [3049] $22,564 160%
90 Degree Benefit [3057] $23,091 164%
Allied National [2031] $23,091 164%
Entrust/90 Degree [2058] $23,091 164%
Kempton Group Administrators, Tower Extrusions [3061] $23,310 165%
Friday Health Plan [2061] $23,790 169%
Ambetter / Centene $23,930 170%
Imperial Insurance Companies [3073] $25,190 178%
Evry Health [1013] $34,986 248%
Medical Cost Containment Professionals [3059] $34,986 248%
Velocity [3070] $34,986 248%
Dart Member Care [3039] $37,785 268%
Healthscope Benefits [2052] $37,785 268%
Healthscope Benefits [3063] $37,785 268%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1201 E Highway 287, Midlothian, TX 76065
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals