CMS Price Transparency Data

Culture, blood

Facility: Adventist Health Delano

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $18
Cash Discount Price: $52
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Adventist Health Delano is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.74x the Medicare baseline. Located in 1401 Garces Highway, Delano, CA.

Cash / Self-Pay

$52

Average discount available for prompt cash payment at this facility.

Insurance Median

$18

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: $52 (504%)

Insurance Median: $18 (174%)

Cash: $52 (504% of Medicare)

Ins. Median: $18 (174% 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.

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 Cross Blue Shield	$3 - $216	29%
Bakersfield Fam Med Grp-All Plans	$10	97%
Healthnet Mcr Adv	$10	97%
Kern Mcr Adv Dual Dnsp-All Other Plans	$10	97%
Medicare (plans)	$10 - $17	97%
Tricare	$10	97%
UnitedHealthcare	$10 - $186	97%
Universal Care Mcr- All Other Plans	$10	97%
Dignty Hlth Mcal Op Only	$12	116%
Kaiser Medi-Cal Ip/Op Only	$12	116%
Medi-Cal	$12	116%
Universal Care Mcal	$12	116%
Healthnet Medi-Cal	$14	136%
Kern Health System Mcal	$15	145%
Kaiser Comm Ip/Op Only- All Other Plans	$18	174%
Ah Employee Health Plan - All Plans	$19	184%
Centivo - All Plans	$23	223%
Blue Shield Epn - All Other Plans	$57	552%
Aetna	$68	659%
Coventry- All Plans	$155	1502%
Blue Shield Non-Epn	$168	1628%
Healthnet- All Other Plans	$174	1686%
County Of Kern Network - All Plans	$181	1754%
Gem Care- All Plans	$181	1754%
Foundation For Medical Care Of Kern County - All P	$194	1880%
Cigna	$207	2006%
Western Growers - All Plans	$210	2035%

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 $52.
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 Delano 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.