CMS Price Transparency Data

Culture, blood

Facility: Banner Heart Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $15
  • Cash Discount Price: $59
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Banner Heart Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.45x the Medicare baseline. Located in 6750 East Baywood Avenue, Mesa, AZ.
Cash / Self-Pay
$59

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $59 (572%)
Insurance Median: $15 (145%)
Cash: $59 (572% of Medicare)
Ins. Median: $15 (145% 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 - $190 97%
Arizona Physicians Ipa $10 97%
Banner Health $10 97%
Banner University Health Plan $10 97%
Blue Cross Blue Shield $10 - $40 97%
Care 1St $10 97%
Cigna $10 - $20 97%
Gila River Health Care Corporation $10 97%
Health Choice Arizona, Inc. $10 - $15 97%
Health Net $10 - $15 97%
Humana $10 - $11 97%
Kaiser Foundation Health Plan $10 97%
Mercy Care $10 97%
Triwest Healthcare Alliance Corp - Va Ccn $10 97%
UnitedHealthcare $10 - $23 97%
Upmc Health Plan $10 97%
Wellpoint $10 97%
Arizona Priority Care $11 107%
Carelon $11 107%
Devoted Health Services $11 107%
Gold Kidney Health Plan $11 107%
Oscar Health Plan $17 165%
Hospice Of The Valley $126 1221%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $162 1570%
Plotkin Health $162 1570%
Quiktrip Corporation $194 1880%
Arizona Medical Network $252 2442%
Provider Network Of America $270 2616%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6750 East Baywood Avenue, Mesa, AZ 85206
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals