CMS Price Transparency Data

Culture, blood

Facility: UCSF Health St. Mary's Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $13
  • Cash Discount Price: $583
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Culture, blood at UCSF Health St. Mary's Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $583. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.26x the Medicare baseline. Located in 450 Stanyan St, San Francisco, CA.
Cash / Self-Pay
$583

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: $583 (5649%)
Insurance Median: $13 (126%)
Cash: $583 (5649% 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
Aetna $10 - $58 97%
Blue Cross Blue Shield $10 - $263 97%
Blue Shield Ca $10 - $306 97%
Brown Toland $10 97%
Chinese Community $10 - $246 97%
Connected Care $10 97%
Health Net $10 - $19 97%
Health Plan San Mateo $10 - $13 97%
Humana $10 97%
Kaiser $10 - $287 97%
Mhn $10 97%
United $10 - $12 97%
California Health & Wellness $13 126%
Partnership Health Plan $13 126%
Sfhp $13 126%
Kentfield $30 291%
Oscar $34 329%
Cigna $45 - $48 436%
Magellan $227 - $473 2200%
Healthsmart $265 - $552 2568%
Multiplan $314 - $654 3043%
Us Behavioral Health $378 3663%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 450 Stanyan St, San Francisco, CA 94117
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals