Culture, blood
Facility: Adventist Health Reedley
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $46
- Cash Discount Price: $60
- vs. Medicare Baseline: 4.46x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 446% of the Medicare baseline (a markup of 346%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bc Mcal | $4 | 39% |
| Blue Shield Mcare | $10 | 97% |
| Dignity Mcr Adv Op/Profee Only | $10 | 97% |
| Fhcn Pace Mcr Adv-All Plans | $10 | 97% |
| Healthnet- Mcr Adv | $10 | 97% |
| Kaiser Mcr Adv | $10 | 97% |
| Phs Prime Health Srvcs | $10 | 97% |
| Tricare | $10 | 97% |
| UnitedHealthcare | $10 - $154 | 97% |
| Cal Viva Hlth Mcal - All Plans | $12 | 116% |
| Kern Health Systems Mcal-All Plans | $12 | 116% |
| Medi-Cal | $12 | 116% |
| Dignity Mcal Op/Profee Only-All Other Plans | $13 | 126% |
| Community Care Ipa Mcal-All Plans | $15 | 145% |
| Bright Health Mcr Adv - All Plans | $16 | 155% |
| Aetna | $17 - $60 | 165% |
| Ah Employee Health Plan - All Plans | $19 | 184% |
| Healthnet Medi-Cal | $40 - $55 | 388% |
| Blue Cross Blue Shield | $46 - $132 | 446% |
| Healthnet- All Other Plans | $117 - $160 | 1134% |
| Blue Shield Epn - All Other Plans | $118 - $162 | 1143% |
| Western Growers/Pinnacle- All Plans | $123 - $169 | 1192% |
| Kaiser - All Other Plans | $134 - $184 | 1298% |
| Blue Shield Non Epn | $137 - $188 | 1328% |
| Cigna | $174 - $239 | 1686% |
| Physicians Med Group Op/Profee Only- All Plans | $214 - $294 | 2074% |