CMS Price Transparency Data

Culture, blood

Facility: Paradise Valley Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $10
  • Cash Discount Price: $10
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Paradise Valley Hospital is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 0.97x the Medicare baseline. Located in 2400 East 4Th St, National City, CA.
Cash / Self-Pay
$10

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $10 (97%)
Insurance Median: $10 (97%)
Cash: $10 (97% of Medicare)
Ins. Median: $10 (97% 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 - $13 97%
Blue Sheid Of Promise $10 97%
Blue Shield Of Ca, Va $10 97%
Brand New Day $10 - $15 97%
Ca Dept Of Correction & Rehab $10 - $14 97%
Ca Foundation For Medical Care $10 97%
Central Health $10 97%
Choice Physicians Network $10 97%
Clever Care Of Golden State, Inc $10 97%
Community Health Group $10 - $12 97%
County Of San Diego $10 97%
Employer Direct Healthcare $10 - $14 97%
Golden Physicians Medical Group $10 - $13 97%
Health Excel Ins $10 97%
Health Net Federal Service (Cdcr) $10 - $13 97%
Health Net Of Ca $10 - $15 97%
Heritage Provider Netwrok $10 - $13 97%
Imperial Health Plan Of Ca $10 - $11 97%
Integrated Medical Solutions $10 - $14 97%
Managed Health Network $10 97%
Medicare (plans) $10 97%
Molina $10 97%
Naphcare $10 - $21 97%
Renal Payer Solutions $10 97%
Scripps Health $10 - $18 97%
Traditional Medi-Cal $10 97%
Tricare $10 97%
UnitedHealthcare $10 - $18 97%
Usa Senior Care Network $10 97%
Verda Health Plan $10 97%
Veterans Evaluation Services $10 - $13 97%
Worker Comp $10 - $14 97%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 East 4Th St, National City, CA 91950
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals