CMS Price Transparency Data

Culture, blood

Facility: Adventist Health Lodi Memorial

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $10
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Adventist Health Lodi Memorial is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 0.97x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $46 (446%)
Insurance Median: $10 (97%)
Cash: $46 (446% of Medicare)
Ins. Median: $10 (97% 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
Medcore(Omni Ipa) Op Only- All Plans $2 - $302 19%
Blue Shield Epn - All Other Plans $3 - $376 29%
Blue Shield Non-Epn $3 - $390 29%
Bc Mcal $4 39%
Healthnet- All Other Plans $4 - $571 39%
Kaiser Commercial - All Other Plans $4 - $476 39%
Networks By Design- All Plans $4 - $581 39%
UnitedHealthcare $4 - $482 39%
First Health- All Plans $7 - $953 68%
Multiplan- All Plans $7 - $930 68%
Beech Street- All Plans $8 - $1,046 78%
Cigna $8 - $1,046 78%
Three Rivers Provider Network- All Plans $8 - $1,046 78%
Western Growers- All Plans $8 - $1,046 78%
Celtic Ins Company - All Plans $9 - $13 87%
Healthnet Mcal $9 - $17 87%
Hp Of San Joaquin Mcal $9 - $15 87%
Hp Of San Joaquin Ppo - All Other Plans $9 - $1,104 87%
Kaiser Mcal $9 - $12 87%
Medi-Cal $9 - $12 87%
Alignment Health Plan (Ahp)-All Plans $10 97%
Blue Shield Mcare Adv $10 97%
Cca Health Plan Mcr Adv- All Plans $10 97%
Healthnet Mcare $10 97%
Hp Of San Joaquin Mcr Adv $10 97%
Humana $10 97%
Kaiser Mcr Adv $10 97%
Tricare $10 97%
Knnex Health - All Plans $12 116%
Ah Employee Health Plan - All Plans $19 184%
Bright Health - All Plans $21 203%
Aetna $34 329%
Blue Cross Blue Shield $102 - $113 988%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals