CMS Price Transparency Data

Culture, blood

Facility: Adventist Health Ukiah Valley

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $138
Cash Discount Price: $53
vs. Medicare Baseline: 13.37x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Adventist Health Ukiah Valley is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 13.37x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$53

Average discount available for prompt cash payment at this facility.

Insurance Median

$138

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: $53 (514%)

Insurance Median: $138 (1337%)

Cash: $53 (514% of Medicare)

Ins. Median: $138 (1337% 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 1337% of the Medicare baseline (a markup of 1237%). 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
Blue Shield Mcr Adv	$10	97%
Kaiser Mcr Adv	$10	97%
Tricare	$10	97%
UnitedHealthcare	$10 - $298	97%
Kaiser Medi-Cal	$12	116%
Medi-Cal	$12	116%
Ah Employee Health Plan - All Plans	$19	184%
Blue Shield Epn-All Other Plans	$64 - $136	620%
Blue Shield Non-Epn	$65 - $138	630%
Western Growers-All Plans	$88 - $186	853%
Aetna	$91	882%
Healthnet-All Plans	$97 - $204	940%
Blue Cross Blue Shield	$104 - $139	1008%
Mendocino Lcc District-All Plans	$110 - $232	1066%
Foundation For Medical Care-All Plans	$127 - $268	1231%
Cigna	$132 - $278	1279%
Kaiser-All Other Plans	$135 - $286	1308%
Networks By Design-All Plans	$135 - $286	1308%
Phcs Multiplan-All Plans	$135 - $286	1308%
Interplan-All Plans	$139 - $293	1347%
Beech Street-All Plans	$144 - $303	1395%
Choice Care-All Plans	$144 - $303	1395%
Health Mgmt Network-All Plans	$144 - $303	1395%
Three Rivers-All Plans	$152 - $321	1473%

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 $53.
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 Adventist Health Ukiah Valley 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.