CMS Price Transparency Data
Culture, blood
Facility: Whittier Hospital Medical Center
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $13
- Cash Discount Price: $19
- vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Whittier Hospital Medical Center is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.26x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
$19
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: $19 (184%)
Insurance Median: $13 (126%)
Cash: $19 (184% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Physician Healthways | $2 - $39 | 19% |
| Physicians Healthways Medical Corporation | $4 - $96 | 39% |
| Ahmc Reciprocity | $5 - $116 | 48% |
| Ahmc Reciprocity Agreement Senior/Commercial | $5 - $116 | 48% |
| Pacific Independent Physician Association | $5 - $116 | 48% |
| Wear And Wood | $5 - $154 | 48% |
| Blue Cross Blue Shield | $6 - $193 | 58% |
| Edward Medical Group | $6 - $135 | 58% |
| UnitedHealthcare | $6 - $336 | 58% |
| Central Health Plan Of California | $7 - $154 | 68% |
| Molina Medical Center | $7 - $151 | 68% |
| Veterans Administration | $7 | 68% |
| Allied Physicians Ipa | $8 - $174 | 78% |
| Ahmc Medi-Cal Reciprocity Agreement | $9 | 87% |
| Aids Healthcare Foundation | $9 - $10 | 87% |
| Allied Physicians | $9 - $15 | 87% |
| Alta Med Health Network | $9 - $10 | 87% |
| Altamed Health Services Corporation | $9 | 87% |
| Beverly Hospital | $9 - $11 | 87% |
| Blue Shield Of California | $9 - $193 | 87% |
| Brand New Day | $9 - $13 | 87% |
| Emanate Health | $9 - $13 | 87% |
| Health Net | $9 - $231 | 87% |
| Healthy Way La | $9 | 87% |
| Heritage Provider Network | $9 - $14 | 87% |
| Kaiser Foundation | $9 - $270 | 87% |
| La Care Healthy Families/Healthy Kids | $9 | 87% |
| Non Contracted Medi-Cal | $9 | 87% |
| Prospect Health Plan | $9 - $17 | 87% |
| Synermed | $9 - $10 | 87% |
| Aetna | $10 - $281 | 97% |
| Alignment Health Plan | $10 | 97% |
| Alta Los Angeles Hospitals Inc | $10 | 97% |
| Apa/Aco Inc | $10 | 97% |
| Avanti | $10 - $12 | 97% |
| Caloptima | $10 - $13 | 97% |
| Care First Health Plan | $10 | 97% |
| Caremore | $10 | 97% |
| Central Health Plan | $10 | 97% |
| County Of Los Angeles Dept Of Health Services | $10 | 97% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $10 | 97% |
| Easy Choice Health Plan | $10 | 97% |
| Hollywood Presbyterian Adv Med Mcal | $10 | 97% |
| Hollywood Presbyterian Medpoint Mcal | $10 | 97% |
| Humana | $10 | 97% |
| La Care Covered Direct | $10 | 97% |
| La Care Health Plan | $10 - $212 | 97% |
| Medi Caid/ Medi Cal | $10 | 97% |
| Medicare (plans) | $10 - $11 | 97% |
| Pacific Alliance Medical Center | $10 | 97% |
| Pacificare Of California | $10 | 97% |
| Private Pay | $10 | 97% |
| Prospect Medical | $10 - $212 | 97% |
| Scan Health Plan | $10 | 97% |
| Self-Pay | $10 | 97% |
| Care 1St Health Plan | $11 - $232 | 107% |
| Molina Healthcare Of California | $11 | 107% |
| New Horizon Medical Group Inc | $11 - $232 | 107% |
| San Miguel Health Plan | $11 | 107% |
| Applecare Medical Group | $12 | 116% |
| Athens Administrators Ahmc Work Comp | $12 | 116% |
| Chinatown Service Center Pace | $12 | 116% |
| Cigna | $12 | 116% |
| Cost Containment | $12 - $251 | 116% |
| Davita Healthcare Partners | $12 - $251 | 116% |
| Fmc Los Angeles County | $12 - $290 | 116% |
| Health Net Inc | $12 - $251 | 116% |
| Healthnet | $12 - $268 | 116% |
| Interplan Health Group | $12 | 116% |
| Misc 1 | $12 | 116% |
| Multiplan Wc | $12 | 116% |
| Tricare | $12 | 116% |
| Universal Care | $12 - $270 | 116% |
| Ahmc Health | $13 | 126% |
| Asi/Flex | $13 - $270 | 126% |
| Knox-Keene Act | $13 | 126% |
| Monarch Healthplan | $13 | 126% |
| Us Comp Care | $13 - $270 | 126% |
| Value Healthplan Of California | $13 - $270 | 126% |
| Community Care Network | $14 - $290 | 136% |
| Coventry Health Care | $14 - $290 | 136% |
| Coventry Health Care National Network | $14 - $290 | 136% |
| Interplan Corporation | $14 - $290 | 136% |
| Managed Care Administrators | $14 - $290 | 136% |
| Prohealth | $14 - $290 | 136% |
| Capnet | $15 | 145% |
| Multiplan | $15 - $328 | 145% |
| Commercial Non Contract | $18 - $386 | 174% |
| Medi-Cal Sub Acute | $18 - $386 | 174% |
| One Legacy | $18 - $386 | 174% |
| Great-West Healthcare Of California | $2,500 | 24225% |