CMS Price Transparency Data
Culture, blood
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $13
- Cash Discount Price: $300
- vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Culture, blood at AHMC Anaheim Regional Medical Center is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $300. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.26x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$300
Average discount available for prompt cash payment at this facility.
Insurance Median
$13
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: $300 (2907%)
Insurance Median: $13 (126%)
Cash: $300 (2907% of Medicare)
Ins. Median: $13 (126% 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
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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% |
| Affiliated Doctors Of Orange County | $8 | 78% |
| Ahmc Reciprocity Agreement | $9 - $110 | 87% |
| Allied Physicians | $9 - $15 | 87% |
| Altamed Health Network | $9 - $10 | 87% |
| Applecare Medical Group | $9 | 87% |
| Beverly Hospital | $9 - $11 | 87% |
| Brand New Day | $9 - $13 | 87% |
| Health Net | $9 | 87% |
| Healthcare Partners | $9 - $10 | 87% |
| Healthy Way La | $9 | 87% |
| Heritage Provider Network | $9 - $14 | 87% |
| Kaiser Foundation Hospitals | $9 - $10 | 87% |
| Medical Safety Net Program | $9 | 87% |
| Non Contracted Medi-Cal | $9 | 87% |
| Prospect Medical Group | $9 | 87% |
| Talbert Medical Group | $9 - $10 | 87% |
| Aetna | $10 - $56 | 97% |
| Aids Health Foundation | $10 | 97% |
| Alignment Health Plan | $10 | 97% |
| Alta Los Angeles Hospital | $10 | 97% |
| Apa Aco Inc | $10 | 97% |
| Avanti | $10 - $12 | 97% |
| Blue Cross Blue Shield | $10 - $38 | 97% |
| Blue Shield Of California | $10 - $139 | 97% |
| California Health Plan | $10 | 97% |
| Caloptima | $10 - $13 | 97% |
| Central Health Of California | $10 | 97% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $10 | 97% |
| Davita Heatlhcare Partners Plan Inc | $10 - $197 | 97% |
| Emanate Health | $10 - $13 | 97% |
| Health Net Inc | $10 - $280 | 97% |
| Healthnet | $10 | 97% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $10 | 97% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $10 | 97% |
| Hollywood Presbyterian Medpoint Mcal | $10 | 97% |
| Humana | $10 | 97% |
| Innovative Integrated Health (Iih)/Orange County Pace | $10 | 97% |
| Medi-Cal | $10 | 97% |
| Medicare (plans) | $10 - $182 | 97% |
| Memorial Healthcare Ipa/Cap/Valuation Rates | $10 | 97% |
| Monarch Health Plan | $10 - $248 | 97% |
| Pacificare | $10 | 97% |
| Private Pay Flat Rate | $10 | 97% |
| Prospect Health Plan | $10 - $14 | 97% |
| Scan Health Plan | $10 | 97% |
| Self-Pay | $10 | 97% |
| Seoul Medical Group | $10 | 97% |
| Wellcare | $10 | 97% |
| Align Senior Care | $11 | 107% |
| Angels Baseball Workers Comp | $11 | 107% |
| Interplan | $11 - $256 | 107% |
| Nchp | $11 | 107% |
| Tricare | $11 | 107% |
| Athens Administrators | $12 | 116% |
| Capp Care | $12 - $274 | 116% |
| Cigna | $12 | 116% |
| Corvel | $12 - $274 | 116% |
| First Health | $12 - $310 | 116% |
| Marriot Intl | $12 | 116% |
| Non Contracted Workers Comp | $12 | 116% |
| Orange County Preferred Provider Organization | $12 - $274 | 116% |
| Ahmc Health Self-Insurance Epo | $13 | 126% |
| Knox-Keene Act | $13 | 126% |
| UnitedHealthcare | $21 - $41 | 203% |
| Monarch Healthcare Medical Group | $26 | 252% |
| Msi/Medical Services For Indigents | $52 | 504% |
| Netcare Life And Health Insurance | $59 - $91 | 572% |
| Advance Clinical Research Institute | $70 - $110 | 678% |
| Memorial Healthcare Ipa | $70 - $110 | 678% |
| Medical Acquisition Company | $94 - $146 | 911% |
| Healthcare Partners Commercial | $127 - $197 | 1231% |
| Huntington Memorial Hospital | $127 - $197 | 1231% |
| Genesis Healthcare Ipa Ancillary | $141 - $219 | 1366% |
| Affiliated Health Fund | $164 - $256 | 1589% |
| Allnet Preferred Provider | $164 - $256 | 1589% |
| Care First | $164 - $256 | 1589% |
| Private Healthcare Systems | $164 - $256 | 1589% |
| Choicecare | $176 - $274 | 1705% |
| Multiplan Inc | $176 - $274 | 1705% |
| National Provider Network | $188 - $292 | 1822% |
| Three Rivers Providers Network | $188 - $292 | 1822% |
| Health Payors Organization | $211 - $328 | 2045% |
| Non Contracted Commercial | $235 - $365 | 2277% |