CMS Price Transparency Data

Culture, blood

Facility: Oak Valley Hospital District

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $278
Cash Discount Price: $360
vs. Medicare Baseline: 26.94x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Oak Valley Hospital District is $278. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $360. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 26.94x the Medicare baseline. Located in 350 S Oak Ave, Oakdale, CA.

Cash / Self-Pay

$360

Average discount available for prompt cash payment at this facility.

Insurance Median

$278

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: $360 (3488%)

Insurance Median: $278 (2694%)

Cash: $360 (3488% of Medicare)

Ins. Median: $278 (2694% 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 2694% of the Medicare baseline (a markup of 2594%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Alignment Op Only Ip/Op Only-All Plans	$10	97%
Humana	$10	97%
Kaiser Mcr Adv Ip/Op Only	$10	97%
Imperial Health Ip/Op Only-All Plans	$11	107%
Scan Health Plan Ip/Op Only-All Plans	$11	107%
Blue Cross Blue Shield	$12 - $432	116%
Healthnet Medi-Cal Ip/Op Only	$12	116%
Kaiser Medi-Cal Ip/Op Only	$12	116%
Medi-Cal Ip/Op Only	$12	116%
Hp Of San Joaquin Ip/Op Only-All Plans	$14	136%
Blue Shield Epn Ip/Op Only	$260	2519%
Healthnet Comm Op Only Ip/Op Only-All Other Plans	$278	2694%
Kaiser Comm Ip/Op Only-All Other Plans	$298	2888%
Blue Shield/Bcout Ip/Op Only-All Other Plans	$317	3072%
Cigna	$322	3120%
UnitedHealthcare	$336	3256%
Aetna	$408	3953%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $360.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87040.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Oak Valley Hospital District is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87040.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.