CMS Price Transparency Data

Culture, blood

Facility: San Antonio Regional Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $33
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 3.20x Medicare
The contracted insurance negotiated median rate for a Culture, blood at San Antonio Regional Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 3.20x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $185 (1793%)
Insurance Median: $33 (320%)
Cash: $185 (1793% of Medicare)
Ins. Median: $33 (320% 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 320% of the Medicare baseline (a markup of 220%). 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
Healthnet Medi-Cal $8 78%
Blue Shield Mcr Adv $10 97%
Caremore Mcr Adv - All Plans $10 97%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $10 97%
Healthnet Mcr Adv $10 97%
Humana $10 97%
Iehp Mcr Adv $10 97%
Inter Valley Hp Mcr Adv- All Plans $10 97%
Kindred Mcr Adv-All Plans $10 97%
Molina Mcr Adv $10 97%
Scan Health Plan Mcr Adv-All Plans $10 97%
Tricare $10 97%
Universal Care - All Plans $10 97%
Blue Cross Blue Shield $11 - $467 107%
Imperial Health Mcr Adv-All Plans $11 107%
Kasiser Mcr Adv $11 107%
Zelis Mcr Adv $11 107%
Kaiser Medi-Cal $12 116%
Medi-Cal $12 116%
Alpha Care Mg Mcal/Hlthy Kids $13 126%
Choice Phycn Ntwrk Op Only $13 126%
Heritage Prov Ntwrk/Regal Mcal $13 126%
Molina Exchange-All Other Plans $13 126%
Aetna $14 - $1,068 136%
Molina Medi-Cal $14 136%
Iehp Comm - All Other Plans $15 145%
Iehp Mcal $15 145%
Redlands Employee $15 145%
Redlands Hmo-All Other Plans $16 155%
Prime Health - All Plans $18 174%
Healthnet - All Other Plans $25 242%
Blue Shield Epn $29 281%
Kaiser Comm - All Other Plans $29 281%
Cigna $38 368%
UnitedHealthcare $110 - $201 1066%
Ambetter / Centene $194 1880%
Epic Health Plan - All Other Plans $320 3101%
Blue Shield Hmo Pos / Calpers Ppo $395 3828%
Blue Shield Epo Ppo - All Other Plans $429 4157%
Pc Inland Valley Scan $534 5174%
Pc Inland Valley-All Other Plans $534 5174%
Coventry Ccn/First Hlth - All Plans $587 5688%
Choicecare Ntwrk-All Plans $769 7452%
Multiplan/Phcs - All Plans $769 7452%
Networks By Design - All Plans $801 7762%
Zelis Comm-All Other Plans $801 7762%
Foundation Inland Epo-All Other Plans $854 8275%
Foundation Inland Ppo $908 8798%
Health Payors - All Plans $961 9312%
Interplan - All Plans $961 9312%
Wellcare/Easy Choice-All Plans $1,047 10145%
Alpha Care Mg Mcr Adv $1,068 10349%
Central Hlth Plan Mcr Adv-All Plans $1,068 10349%
Epic Health Plan Mcr Adv $1,068 10349%
Prospect Hp-All Plans $1,068 10349%
Providence Clevercare Mcr Adv $1,068 10349%
Heritage Prov Ntwrk/Regal Mcr Adv $1,084 10504%
Clever Care Mcr Adv - All Plans $1,121 10862%
La Salle Hp Mcr Adv-All Plans $1,121 10862%
Providence Oscar-All Other Plans $1,121 10862%
Alpha Care Mg-All Other Plans $1,335 12936%
Heritage Prov Ntwrk/Regal - All Other Plans $1,962 19012%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals