CMS Price Transparency Data

Culture, blood

Facility: AHMC Seton Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $13
  • Cash Discount Price: $340
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Culture, blood at AHMC Seton Medical Center is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $340. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.26x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
$340

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: $340 (3295%)
Insurance Median: $13 (126%)
Cash: $340 (3295% 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

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 (Va) $7 68%
Medi-Cal $9 87%
Aetna $10 - $31 97%
Apcmg $10 - $15 97%
Asian American Medical Group $10 - $13 97%
Blue Cross Blue Shield $10 - $323 97%
Blue Shield Of California $10 - $131 97%
Brand New Day $10 - $13 97%
Brown And Toland Medical Group $10 - $13 97%
Canopy Health $10 - $19 97%
Care Advantage $10 97%
Chinese Community Health Plan $10 - $212 97%
Cmac $10 97%
Covid-19 Uninsured Program $10 97%
For Your Benefit $10 97%
Healthnet Seniority $10 97%
Hill Physicians Medical Group Inc $10 - $12 97%
Humana $10 97%
Imperial Health Plan $10 97%
Jade Health Care Mg $10 - $212 97%
Kaiser $10 - $348 97%
Medicare (plans) $10 97%
North East Medical Services $10 - $13 97%
Pacificare $10 97%
UnitedHealthcare $10 - $21 97%
Central Health Plan $11 107%
Easy Choice Hospital Services $11 107%
San Mateo County/San Mateo County General Hospital $11 107%
Athens Administrators $12 116%
Corvel Healthcare $12 116%
Multiplan/Bce Emergis $12 - $319 116%
Tricare $12 116%
Work Comp Other $12 116%
Ahmc Health $13 126%
Health Plan Of San Mateo Healthworx $13 126%
Knox-Keene Act $13 126%
San Francisco Health Plan $13 126%
Health Plan Of San Mateo $14 136%
Cigna $54 523%
Self Pay $64 - $144 620%
Interplan Corporation $255 2471%
Healthcare Foundation Of San Mateo $298 - $319 2888%
Private Healthcare Sytems Inc $319 3091%
The First Health Network $319 3091%
Health Net $326 3159%
Beech Street Corporation $340 3295%
Choicecare Network $361 3498%
Multiplan $361 3498%
Mills Peninsula Health Services $382 3702%
Indemnity $425 4118%
Workers Compensation Federal $425 4118%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals