CMS Price Transparency Data

Culture, blood

Facility: Adventist Health Howard Memorial

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $310
Cash Discount Price: $138
vs. Medicare Baseline: 30.04x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Adventist Health Howard Memorial is $310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $138. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 30.04x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$138

Average discount available for prompt cash payment at this facility.

Insurance Median

$310

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: $138 (1337%)

Insurance Median: $310 (3004%)

Cash: $138 (1337% of Medicare)

Ins. Median: $310 (3004% 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 3004% of the Medicare baseline (a markup of 2904%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medi-Cal	$12	116%
Blue Shield Mcare	$83 - $101	804%
Medicare (plans)	$83 - $102	804%
Tricare	$83 - $101	804%
UnitedHealthcare	$91 - $390	882%
Blue Cross Blue Shield	$103 - $123	998%
Ah Employee Health Plan - All Plans	$215 - $262	2083%
Aetna	$277 - $338	2684%
Blue Shield Epn	$282 - $345	2733%
Blue Shield - All Other Plans	$283 - $345	2742%
Western Growers/Pinnacle - All Plans	$310 - $378	3004%
First Health Ppo - All Plans	$330 - $403	3198%
Ghn Ppo - All Plans	$330 - $403	3198%
Healthnet - All Plans	$339 - $413	3285%
Brms - All Plans	$351 - $428	3401%
Cigna	$351 - $428	3401%

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 $138.
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 Adventist Health Howard Memorial 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.