CMS Price Transparency Data

Culture, blood

Facility: Martin Luther King, Jr. Community Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $12
Cash Discount Price: $17
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Martin Luther King, Jr. Community Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.16x the Medicare baseline. Located in 1680 East 120Th Street, Los Angeles, CA.

Cash / Self-Pay

$17

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: $17 (165%)

Insurance Median: $12 (116%)

Cash: $17 (165% 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.

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
Preferred Professional Medical Corporation (Ipa) Of California	$6	58%
Alta	$9 - $10	87%
Brand New Day	$9 - $55	87%
Care1St Health	$9 - $10	87%
Molina Healthcare	$9 - $13	87%
Heritage Provider Network (Hpn)	$10	97%
Health Net	$12 - $27	116%
La Care Health Pasc-Seui	$12	116%
La Care Health Plan	$12	116%
UnitedHealthcare	$14	136%
La Care Health	$16	155%
Santa Monica Unite Here	$36	349%
Blue Shield Of California	$37 - $41	359%
Multiplan	$73	707%

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 $17.
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 Martin Luther King, Jr. Community Hospital 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.