CMS Price Transparency Data
Culture, blood
Facility: Menifee Global Medical Center
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $12
- Cash Discount Price: $410
- vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Menifee Global Medical Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $410. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.16x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
$410
Average discount available for prompt cash payment at this facility.
Insurance Median
$12
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: $410 (3973%)
Insurance Median: $12 (116%)
Cash: $410 (3973% of Medicare)
Ins. Median: $12 (116% 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 |
|---|---|---|
| Blue Cross Blue Shield | $9 | 87% |
| Ic | $9 - $410 | 87% |
| Kaiser Medi-Cal | $9 | 87% |
| Tricare | $9 - $10 | 87% |
| Aetna | $10 - $260 | 97% |
| Altamed Comm Hmo (Ancillary) | $10 - $410 | 97% |
| Altamed Health Services Senior | $10 | 97% |
| Altamed Sr/Pace | $10 | 97% |
| Blue Shield Senior | $10 | 97% |
| Central Health Plan Senior | $10 | 97% |
| Clever Care Health Plan Sr | $10 | 97% |
| For Your Benefit Senior | $10 | 97% |
| Guidant Health Plan Senior | $10 | 97% |
| Health Net Medi-Cal | $10 | 97% |
| Health Net Senior | $10 | 97% |
| Hpn Mcal | $10 | 97% |
| Hpn Senior | $10 | 97% |
| Humana | $10 | 97% |
| Imperial Health Plan Of Ca | $10 | 97% |
| Kaiser Senior | $10 | 97% |
| Lasalle Medical Assoc (Ancillary) Commercial | $10 | 97% |
| Lasalle Medical Assoc (Ancillary) Senior | $10 | 97% |
| Managed Health Network Sr | $10 | 97% |
| Medicare (plans) | $10 | 97% |
| Neighborhood Healthcare Pace | $10 | 97% |
| Point Comfort Underwriters | $10 | 97% |
| Primecare Senior | $10 | 97% |
| Prospect Health Plan Sr Hmo | $10 | 97% |
| Scan Senior | $10 | 97% |
| Self Pay/Ab774/Charity Discount | $10 | 97% |
| Sr Capitation | $10 | 97% |
| UnitedHealthcare | $10 - $12 | 97% |
| Veterans Administration | $10 | 97% |
| Coventry | $11 - $12 | 107% |
| Lasalle Medical Assoc (Ancillary) Mcal Hmo | $11 | 107% |
| Molina Medi-Cal | $11 | 107% |
| Prime Health Services Wcomp | $11 | 107% |
| Prospect Health Plan Mcal Hmo | $11 | 107% |
| Align Senior Care | $12 | 116% |
| Prime Health Services Senior | $12 | 116% |
| Three Rivers Wcomp | $12 | 116% |
| Welbehealth Sr/Pace | $12 | 116% |
| Workers Comp Non-Contracted | $12 | 116% |
| Iehp Covered Ca | $13 | 126% |
| Iehp Medi-Cal | $13 | 126% |
| Molina Covered Ca | $13 | 126% |
| Altamed Mcal Hmo | $14 | 136% |
| Altamed Mcal/Pace | $14 | 136% |
| Choice Physicians Network | $14 | 136% |
| Health Net Enhanced Ppo | $14 | 136% |
| Hpn Commercial/Covered Ca | $14 | 136% |
| Prospect Health Plan Comm Hmo | $14 | 136% |
| Health Net Comm | $15 | 145% |
| Three Rivers Network | $18 | 174% |
| Velocity | $18 - $184 | 174% |
| Cigna | $21 - $328 | 203% |
| Blue Shield Epn | $29 | 281% |
| Blue Shield Commercial | $34 | 329% |
| First Health Commercial | $215 | 2083% |
| Primecare Commercial | $266 | 2578% |
| Multiplan Ppo | $287 | 2781% |
| Multiplan Wcomp | $287 | 2781% |
| Pnoa-Provider Network Of America | $328 | 3178% |
| Prime Health Services Commercial | $328 | 3178% |
| Ava Hospice | $410 | 3973% |
| Kaiser Commercial | $410 | 3973% |
| Living Waters Hospice | $410 | 3973% |
| Managed Health Network | $410 | 3973% |
| Other Insurance Loa | $410 | 3973% |
| Pacific Valley Hospice | $410 | 3973% |
| Private Pay | $410 | 3973% |
| Silverado Hospice | $410 | 3973% |
| Vna Hospice | $410 | 3973% |