CMS Price Transparency Data

Culture, blood

Facility: El Centro Regional Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $181
  • Cash Discount Price: $225
  • vs. Medicare Baseline: 17.54x Medicare
The contracted insurance negotiated median rate for a Culture, blood at El Centro Regional Medical Center is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 17.54x the Medicare baseline. Located in 1415 Ross Avenue, El Centro, CA.
Cash / Self-Pay
$225

Average discount available for prompt cash payment at this facility.

Insurance Median
$181

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: $225 (2180%)
Insurance Median: $181 (1754%)
Cash: $225 (2180% of Medicare)
Ins. Median: $181 (1754% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1754% of the Medicare baseline (a markup of 1654%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $10 - $322 97%
Brand New Day Comm - All Other Plans $10 97%
Brand New Day Mcr $10 97%
Healthnet Mcr Adv $10 97%
Molina Mcr Adv $10 97%
Scp Managed Care - All Plans $10 97%
Tricare $10 97%
UnitedHealthcare $10 - $161 97%
Easy Choice Mcr Adv-All Plans $11 107%
Cdcr Correctional-All Plans $13 126%
Healthnet Hmo $13 126%
Blue Shield-All Plans $65 630%
Aetna $142 1376%
Pacificare-All Plans $200 1938%
Mulitplan Primary - All Other Plans $219 2122%
Cigna $242 2345%
Multiplan Comp $258 2500%
Trident - All Plans $274 2655%
Healthnet Comm-All Other Plans $290 2810%
Humana $299 2897%
Ahccs/Medi-Cal Misc - All Plans $322 3120%
Brand New Day Mcal $322 3120%
Medi-Cal $322 3120%
Molina Exchange - All Other Plans $322 3120%
Ambetter / Centene $332 3217%
Molina Mcal $354 3430%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1415 Ross Avenue, El Centro, CA 92243
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals