CMS Price Transparency Data

Culture, blood

Facility: Alhambra Hospital Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $12
  • Cash Discount Price: $515
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Alhambra Hospital Medical Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $515. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.16x the Medicare baseline. Located in 100 S Raymond Ave, Alhambra, CA.
Cash / Self-Pay
$515

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: $515 (4990%)
Insurance Median: $12 (116%)
Cash: $515 (4990% 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
Stewart Mg Senior Hmo $7 68%
Ahmc-Reciprocity-Medi-Cal/Healthy Families $9 87%
Citrus Valley Health Partners $9 87%
Kaiser Medi-Cal $9 87%
La Care Pasc Seiu Misc $9 87%
Miscellaneous Medi-Cal Hmo $9 87%
Aetna $10 - $17 97%
Allied Physicians Of Ca Medi-Cal $10 97%
Altamed Senior Services $10 97%
Apa Aco $10 97%
Blue Cross Blue Shield $10 - $19 97%
Blue Shield 65 Plus $10 97%
Brand New Day Sr $10 97%
Central Health Plan Of Ca Senior Hmo $10 97%
Health Net Medi-Cal $10 97%
Health Net Senior Hmo $10 97%
Humana $10 97%
La Care Exchange $10 97%
La Care Medi-Cal Hmo $10 97%
Medi-Cal $10 97%
Medicare (plans) $10 - $309 97%
Miscellaneous Senior Hmo $10 97%
UnitedHealthcare $10 - $21 97%
Wellcare Senior Hmo $10 97%
Alignment Senior Hmo $11 107%
Cigna $12 - $232 116%
Miscellaneous Work Comp Hmo $12 116%
Tricare $12 116%
Health Net Exchange $13 126%
Health Net Salud Con Hmo $13 126%
Molina Exchange $13 126%
Ahmc Health $15 145%
Allied Physicians Of Ca Commercial $15 145%
Health Net Ppo/Epo/Pos $22 213%
Blue Shield Value Network Exchange $129 1250%
Blue Shield Hmo/Ppo $143 1386%
Ahmc-Reciprocity-Comm/Senior $155 1502%
Allied Physicians Comm/Sr $180 1744%
Allied Physicians Medi-Cal $180 1744%
Wellcare Allied Senior Hmo $180 1744%
Molina Health Plan $201 1948%
Self Pay $206 1996%
Health Net Exchange Enhanced Ppo $218 2112%
Kaiser Commercial $319 3091%
Scan Senior Plan $335 3246%
Multiplan $412 3992%
Miscellaneous Commercial Ppo/Hmo $515 4990%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 S Raymond Ave, Alhambra, CA 91801
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals