CMS Price Transparency Data

Culture, blood

Facility: Oro Valley Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $15
  • Cash Discount Price: $265
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Oro Valley Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.45x the Medicare baseline. Located in 1551 East Tangerine Road, Oro Valley, AZ.
Cash / Self-Pay
$265

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: $265 (2568%)
Insurance Median: $15 (145%)
Cash: $265 (2568% 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 - $153 97%
Blue Cross Blue Shield $10 - $123 97%
Caremore Health Plan $10 97%
Cigna $10 - $17 97%
Clover Health Mcr Adv $10 97%
Department Of Veterans Affairs $10 97%
Fresenius Health $10 97%
Humana $10 97%
Medicaid / KanCare $10 - $11 97%
Medicare (plans) $10 97%
Node Devoted Health Mcr Adv $10 97%
Node Non Par Hospice Agree $10 97%
Node Triwest $10 97%
Node Va $10 97%
Pascua Yaqui Tribe $10 97%
Scan Health $10 97%
Tricare $10 97%
UnitedHealthcare $10 - $12 97%
Veterans Eval Services $10 97%
Magellan $11 - $482 107%
Node Banner Mcr Adv $11 107%
Wellcare Mcr Adv $11 107%
Node Us Dept Of Labor $13 126%
Ambetter / Centene $15 145%
Node Health Choice Exchange $15 145%
Node Fusion Network $19 184%
Node J Allen Inmate Health Svcs $20 194%
Health Net $22 213%
Seven Corners $24 233%
Self Pay $193 - $338 1870%
Beacon Health Options $402 3895%
Mtc $402 3895%
First Health Coventry $422 4089%
Coventry Work Comp Al $482 4671%
Multiplan $667 6463%
Prime Health $683 6618%
Three Rivers $683 6618%
Healthsmart $724 7016%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1551 East Tangerine Road, Oro Valley, AZ 85755
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals