CMS Price Transparency Data
Culture, blood
Facility: Greater El Monte Community Hospital
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $11
- Cash Discount Price: $98
- vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Greater El Monte Community Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$98
Average discount available for prompt cash payment at this facility.
Insurance Median
$11
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: $98 (950%)
Insurance Median: $11 (107%)
Cash: $98 (950% of Medicare)
Ins. Median: $11 (107% 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 |
|---|---|---|
| Care 1St Medi Cal Hmo Cap Exceptional Care | $1 - $62 | 10% |
| Care First Health Plan | $1 - $62 | 10% |
| Clinica Medica Familiar | $1 - $310 | 10% |
| Alta Med Health Services Med Grp | $2 - $155 | 19% |
| Bella Vista Medical Group Ipa | $2 - $279 | 19% |
| Employee Health Systems Medical Group | $2 - $124 | 19% |
| Global Care Medical Group Ipa | $2 - $279 | 19% |
| Ahmc Reciprocity Agreement | $3 - $186 | 29% |
| Ahmc Reciprocity Agreement Senior/Commercial | $3 - $186 | 29% |
| Allied Physicians Medical Group | $3 - $186 | 29% |
| Good Samaritan Medical Practice Assoc | $3 - $372 | 29% |
| Lincoln Hospital Medical Center | $3 - $186 | 29% |
| Blue Cross Blue Shield | $4 - $310 | 39% |
| Molina Healthcare Of California | $4 - $242 | 39% |
| Blue Shield Of California | $5 - $310 | 48% |
| California Thoroughbred Horesmans Foundation | $5 - $310 | 48% |
| Universal Care | $5 - $434 | 48% |
| Care 1St Health Plan | $6 - $372 | 58% |
| Cost Containment Strategies | $6 - $403 | 58% |
| Health Net Foundation | $6 - $403 | 58% |
| In Custody Police Dept | $6 - $403 | 58% |
| Interplan | $6 - $465 | 58% |
| La Care Health Plan | $6 - $341 | 58% |
| Central Health Plan | $7 - $434 | 68% |
| Health Net Inc | $7 - $439 | 68% |
| UnitedHealthcare | $7 - $532 | 68% |
| Veterans Administration | $7 | 68% |
| Community Care Network | $8 - $496 | 78% |
| Multiplan | $8 - $527 | 78% |
| Ahmc Healthcare Inc | $9 | 87% |
| Aids Health Foundation | $9 - $10 | 87% |
| Altamed Health Network | $9 - $10 | 87% |
| Avanti | $9 - $12 | 87% |
| Beverly Hospital | $9 - $11 | 87% |
| Brand New Day | $9 - $13 | 87% |
| Emanate Health | $9 - $13 | 87% |
| Health Payors Organization | $9 - $558 | 87% |
| Healthy Way La | $9 | 87% |
| Other Non Contracted Medi-Cal Hmo | $9 | 87% |
| Pacificare Of California | $9 - $537 | 87% |
| State Of California | $9 | 87% |
| Ahmc Health Self-Insurance Epo | $10 - $13 | 97% |
| Alignment Health Plan | $10 | 97% |
| Allied Physicians | $10 - $15 | 97% |
| Apa/Aco Inc | $10 | 97% |
| Associated Hispanic Physicians | $10 - $11 | 97% |
| Athens Administrators | $10 - $12 | 97% |
| Caloptima | $10 - $13 | 97% |
| Champus Foundation | $10 - $12 | 97% |
| Cms | $10 | 97% |
| Commercial Non Contract | $10 - $620 | 97% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $10 | 97% |
| Easy Choice Health Plan | $10 | 97% |
| Hollywood Presbyterian Adv Med Mcal | $10 - $11 | 97% |
| Hollywood Presbyterian Medpoint Mcal | $10 - $11 | 97% |
| Inter Valley Health Plan | $10 - $11 | 97% |
| Intercomp | $10 - $11 | 97% |
| Knox-Keene Act | $10 - $13 | 97% |
| La Care Covered Direct | $10 | 97% |
| Medi-Cal Sub Acute | $10 - $620 | 97% |
| Molina Healthcare | $10 - $11 | 97% |
| Nuclear Medicine/Whmc | $10 - $620 | 97% |
| One Legacy | $10 - $620 | 97% |
| Other Non Contracted Senior Hmo | $10 | 97% |
| Other Non Contracted Work Comp | $10 - $12 | 97% |
| Pacific Alliance Medical Center Reciprocal Contract | $10 | 97% |
| Preferred Health Network | $10 - $12 | 97% |
| San Miguel Health Plan | $10 - $11 | 97% |
| Scan Health Plan | $10 | 97% |
| Self-Pay | $10 | 97% |
| Chinatown Service Center Pace | $12 | 116% |
| Cigna | $12 | 116% |
| In Custody-Ca Highway Patrol | $20 | 194% |