CMS Price Transparency Data

Culture, blood

Facility: Sharp Chula Vista Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $269
Cash Discount Price: $317
vs. Medicare Baseline: 26.07x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Sharp Chula Vista Medical Center is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $317. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 26.07x the Medicare baseline. Located in 751 Medical Center Court, Chula Vista, CA.

Cash / Self-Pay

$317

Average discount available for prompt cash payment at this facility.

Insurance Median

$269

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: $317 (3072%)

Insurance Median: $269 (2607%)

Cash: $317 (3072% of Medicare)

Ins. Median: $269 (2607% 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 2607% of the Medicare baseline (a markup of 2507%). 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
Interplan	$25 - $266	242%
Allianz Global Assistance	$27 - $316	262%
Community Health Group	$125 - $295	1211%
Aetna	$143 - $295	1386%
Molina	$177 - $285	1715%
Health Net	$202 - $338	1957%
Indian Health Council	$202	1957%
Blue Shield	$203 - $280	1967%
UnitedHealthcare	$235 - $268	2277%
Blue Cross Blue Shield	$257 - $325	2490%
Managed Health Network	$268	2597%
Epic Americas	$276	2674%
Medicare (plans)	$291	2820%
California Health And Wellness	$295	2859%
Kaiser	$295	2859%
San Diego Pace	$316	3062%
Medi-Cal	$346	3353%

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 $317.
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 Sharp Chula Vista Medical Center 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.