CMS Price Transparency Data

Culture, blood

Facility: Northwest Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $13
  • Cash Discount Price: $241
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Northwest Medical Center is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.26x the Medicare baseline. Located in 6200 North La Cholla Boulevard, Tucson, AZ.
Cash / Self-Pay
$241

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$10.32

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.32 (100%)
Cash / Self-Pay: $241 (2335%)
Insurance Median: $13 (126%)
Cash: $241 (2335% of Medicare)
Ins. Median: $13 (126% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $10.32 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
Aetna $10 - $362 97%
Blue Cross Blue Shield $10 - $121 97%
Cigna $10 - $17 97%
Department Of Veterans Affairs $10 97%
Fresenius Health $10 97%
Humana $10 97%
Medicaid / KanCare $10 - $11 97%
Medicare (plans) $10 97%
Node Caremore Mcr Adv $10 97%
Node Clover Health Mcr Adv $10 97%
Node Devoted Health Mcr Adv $10 97%
Node Non Par Hospice Agree $10 97%
Node Va $10 97%
Pascua Yaqui Tribe $10 97%
Scan Health Plan $10 97%
Tricare $10 97%
Triwest $10 97%
UnitedHealthcare $10 - $402 97%
Veterans Eval Services $10 97%
Magellan $11 107%
Node Banner Mcr Adv $11 107%
Wellcare $11 107%
Node Us Dept Of Labor $13 126%
Ambetter / Centene $15 145%
Node Health Choice Health Exchange $15 145%
Health Net $16 155%
Node Fusion Network $19 184%
Node J Allen Inmate Health Svcs $20 194%
Seven Corners $24 233%
Self Pay $193 - $289 1870%
First Health Coventry $422 4089%
Coventry Medical Center $482 4671%
Multiplan $667 6463%
Prime Health $683 6618%
Healthsmart $724 7016%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6200 North La Cholla Boulevard, Tucson, AZ 85741
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals