CMS Price Transparency Data

Culture, blood

Facility: Adventist Health Tehachapi Valley

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $101
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 9.79x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Adventist Health Tehachapi Valley is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 9.79x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $115 (1114%)
Insurance Median: $101 (979%)
Cash: $115 (1114% of Medicare)
Ins. Median: $101 (979% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 979% of the Medicare baseline (a markup of 879%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Bc Mcal $12 116%
Kaiser Medi-Cal Ip/Op Only $12 116%
Medi-Cal $12 116%
Universal Ipa Mcal Op/Profee Only $12 116%
Healthnet Medi-Cal $15 145%
Khs-Kern Hlth Systm Mcal $15 145%
Oscar Health Plan- All Plans $17 165%
UnitedHealthcare $20 - $322 194%
Healthnet Mcare $37 - $125 359%
Medicare (plans) $37 - $125 359%
Tricare $37 - $125 359%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla $37 - $125 359%
Network Providers- All Plans $47 - $160 455%
Aetna $61 591%
Kaiser Ip/Op Only- All Other Plans $63 - $215 610%
Western Grwrs/Pinnacle - All Plans $81 - $276 785%
Blue Shield Epn- All Other Plans $82 - $278 795%
Centivo - All Plans $83 - $281 804%
Blue Shield Non-Epn $96 - $328 930%
Klhp-Kern Legacy Epo -All Other Plans $96 - $328 930%
Blue Cross Blue Shield $100 - $379 969%
Ah Employee Health Plan - All Plans $102 - $348 988%
Healthnet- All Other Plans $149 - $506 1444%
Cigna $151 - $513 1463%
Coventry- All Plans $174 - $591 1686%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Magellan, Tehachapi, CA 93561
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals