CMS Price Transparency Data
Culture, blood
Facility: Coastal Communities Hospital
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $13
- Cash Discount Price: $57
- vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Coastal Communities Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.26x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
$57
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: $57 (552%)
Insurance Median: $13 (126%)
Cash: $57 (552% 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 |
|---|---|---|
| Monarch | $9 - $11 | 87% |
| Altamed Health Services | $10 - $14 | 97% |
| Altamed Mcal Hmo (Ancillary) | $10 | 97% |
| Blue Shield | $10 - $39 | 97% |
| Caloptima | $10 - $14 | 97% |
| Central Health Plan Of California | $10 | 97% |
| Champion Health Plan | $10 | 97% |
| Choice Physicians Network | $10 | 97% |
| Citizens Choice Health Plan | $10 | 97% |
| Clever Care Health Plan | $10 | 97% |
| Easy Choice Health Plan | $10 | 97% |
| For Your Benefit | $10 | 97% |
| Health Net | $10 - $42 | 97% |
| Healthcare Partners | $10 | 97% |
| Healthcare Partners Sr Hmo | $10 | 97% |
| Heritage | $10 | 97% |
| Hollywood Presbyterian | $10 | 97% |
| Humana | $10 | 97% |
| Imperial Health Plan Of Ca | $10 | 97% |
| Innovative Integrated Health | $10 | 97% |
| Kaiser | $10 - $35 | 97% |
| Kpc Healthcare Inc | $10 - $14 | 97% |
| Medcare Partners | $10 | 97% |
| Medi-Cal Hmo/Non Contract | $10 | 97% |
| Medicaid / KanCare | $10 | 97% |
| Onecare | $10 | 97% |
| Onecare Connect | $10 | 97% |
| Other Senior Non Contract | $10 | 97% |
| Prospect Health Plan | $10 - $15 | 97% |
| Scan Health Plan | $10 | 97% |
| Self Pay Ab774/Cbo Use Only | $10 | 97% |
| UnitedHealthcare | $10 | 97% |
| Us Dept Of Labor | $10 | 97% |
| Us Federal Marshall/Department Of Immigration | $10 | 97% |
| Velocity Provider Network Sr | $10 | 97% |
| Verda Health Plan Sr | $10 | 97% |
| Veterans Administration | $10 | 97% |
| Victim Of Violent Crime | $10 | 97% |
| Victoria Hospice | $10 | 97% |
| Champus | $11 | 107% |
| Coventry Auto Network | $11 | 107% |
| Interplan | $11 - $43 | 107% |
| Prime Health Srvs/Wc | $11 | 107% |
| Brand New Day | $12 | 116% |
| Coventry Wc | $12 | 116% |
| Monarch Health Plan | $12 | 116% |
| Multiplan | $12 - $40 | 116% |
| Prime Health Srvs | $12 - $46 | 116% |
| Three Rivers | $12 | 116% |
| Velocity National Provider Network Wc | $12 | 116% |
| Workers Comp State Of California | $12 | 116% |
| County Of Orange/Custody/Advanced Medmgt | $13 | 126% |
| Veterans Evaluation Services | $13 | 126% |
| Choc Health Alliance | $14 | 136% |
| County Of Orange | $14 | 136% |
| Family Choice | $14 | 136% |
| Heritage Provider Network | $14 - $34 | 136% |
| Staywell/Island Home Ins | $14 | 136% |
| Ihhi Reciprocity | $17 | 165% |
| Three Rivers Network | $18 | 174% |
| Velocity National Provider Network Ppo | $18 | 174% |
| Cigna | $21 - $37 | 203% |
| First Health | $30 | 291% |
| Aetna | $34 | 329% |
| Magellan | $34 | 329% |
| Networks By Design | $40 | 388% |
| Networks By Design Wc | $40 | 388% |
| Healthsmart | $43 | 417% |
| Prime Health | $43 | 417% |
| Pnoa-Provider Network Of America | $46 | 446% |
| Prime Health Srvs/Network | $48 | 465% |
| Lucet Behavioral Health Sr | $57 | 552% |
| Managed Health Network | $57 | 552% |
| Other Insurance Loa | $57 | 552% |
| Other Non Contracted Plans | $57 | 552% |
| Private Pay | $57 | 552% |
| Us Behavioral Health Plan | $57 | 552% |
| Vitas Hospice | $57 | 552% |