CMS Price Transparency Data

Culture, blood

Facility: San Gabriel Valley Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $12
  • Cash Discount Price: $216
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Culture, blood at San Gabriel Valley Medical Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.16x the Medicare baseline. Located in 438 W Las Tunas Drive, San Gabriel, CA.
Cash / Self-Pay
$216

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: $216 (2093%)
Insurance Median: $12 (116%)
Cash: $216 (2093% 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
Veterans Administration $7 68%
Ahmc Medi-Cal Reciprocity $9 87%
Allied Physicians $9 - $15 87%
Altamed Health Network $9 - $10 87%
Beverly Hospital $9 - $11 87%
Brand New Day $9 - $252 87%
Emanate Health $9 - $13 87%
Healthnet Medi-Cal Non-Contract $9 87%
Healthy Way La $9 87%
Non Contracting Medi Cal $9 87%
Aetna $10 - $18 97%
Aids Healthcare Foundation $10 - $288 97%
Alignment Health Plan $10 97%
Apa/Aco Inc $10 97%
Avanti $10 - $12 97%
Blue Cross Blue Shield $10 - $50 97%
Blue Shield Of California $10 - $145 97%
Central Health Plan $10 - $431 97%
Cv-19 Hrsa Uninsured Testing And Tx $10 97%
Health Net $10 - $418 97%
Health Net Inc $10 - $24 97%
Hollywood Presbyterian Adv Med Mcal $10 97%
Hollywood Presbyterian Medpoint Mcal $10 97%
Humana $10 97%
Inter Valley Health Plan $10 97%
La Care Health Plan $10 97%
Medicaid / KanCare $10 97%
Medicare (plans) $10 97%
Molina Healthcare Of California $10 - $280 97%
Pacific Alliance Medical Center $10 97%
Pacificare Of California $10 - $235 97%
Physicians Healthways $10 97%
Providence Health Network $10 97%
Self-Pay $10 97%
St Vincent Medical Center/Psych $10 97%
Tricare $10 97%
Wellcare $10 97%
Athens Administrators $12 116%
Beech Street $12 - $575 116%
Chinatown Service Center Pace $12 116%
Cigna $12 116%
Other Non Contracting Workers Comp $12 116%
Ahmc Health Self-Insurance Epo $13 126%
Care 1St Health Plan $13 - $467 126%
Knox-Keene Act $13 126%
UnitedHealthcare $21 - $41 203%
Private Pay $30 291%
Ahmc Reciprocity $216 2093%
Alignment Healthplan $252 2442%
Clever Care $252 2442%
Pacific Independent Physician Associates $288 2791%
Facey Medical $360 3488%
Community Care Network $467 4525%
Choicecare Network $503 4874%
Private Healthcare Systems (Phcs) $503 4874%
Affiliated Health Fund $539 5223%
Multiplan $647 6269%
Ppo Next $647 6269%
Managed Health Network $719 6967%
Medi-Cal Sub Acute $719 6967%
One Legacy $719 6967%
Other Non Contracted Commercial $719 6967%
Us Behavioral Health Plan $719 6967%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 438 W Las Tunas Drive, San Gabriel, CA 91776
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals