CMS Price Transparency Data

Culture, blood

Facility: St Rose Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $12
  • Cash Discount Price: $65
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Culture, blood at St Rose Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.16x the Medicare baseline. Located in 27200 Calaroga Ave, Hayward, CA.
Cash / Self-Pay
$65

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $65 (630%)
Insurance Median: $12 (116%)
Cash: $65 (630% of Medicare)
Ins. Median: $12 (116% 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 $6 - $211 58%
Healthnet Of California $8 - $295 78%
Interplan $8 - $295 78%
Cigna $9 - $316 87%
Kaiser Foundation Hospitals $9 - $337 87%
Multiplan Inc $9 - $324 87%
UnitedHealthcare $9 - $337 87%
Brown & Toland $10 97%
Centers For Elder Independence $10 97%
Humana $10 97%
Imperial Health Senior $10 97%
Medicare (plans) $10 97%
Preferred Health Network $10 - $358 97%
Blue Cross Blue Shield $12 - $29 116%
Canopy $20 194%
Blue Shield $26 252%
Blue Shield Affinity $26 252%
Blue Shield Hill $26 252%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 27200 Calaroga Ave, Hayward, CA 94545
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals