CMS Price Transparency Data

Culture, blood

Facility: San Luis Valley Regional Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $142
Cash Discount Price: $87
vs. Medicare Baseline: 13.76x Medicare

The contracted insurance negotiated median rate for a Culture, blood at San Luis Valley Regional Medical Center is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 13.76x the Medicare baseline. Located in 106 Blanca Ave, Alamosa, CO.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$142

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: $87 (843%)

Insurance Median: $142 (1376%)

Cash: $87 (843% of Medicare)

Ins. Median: $142 (1376% 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 1376% of the Medicare baseline (a markup of 1276%). 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
Kaiser	$10 - $151	97%
Tricare	$10	97%
Triwest	$10	97%
Presbyterian Health Plan	$23	223%
Aetna	$46 - $139	446%
Co Choice Healthplan - Lutheran Hosp Assoc	$108	1047%
Hmo Health Plans	$111	1076%
Blue Cross Blue Shield	$140	1357%
Galaxy Health Network	$140	1357%
Multiplan	$140 - $143	1357%
UnitedHealthcare	$140 - $146	1357%
Humana	$143	1386%
Pinnacol Assurance	$148	1434%
Colorado Access	$150	1453%
Cigna	$151	1463%
Foundation Health Corp	$151	1463%
Rocky Mountain	$151	1463%
Uc Health Plan	$151	1463%
Uchpa Phs	$151	1463%

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 $87.
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 San Luis Valley Regional Medical Center 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.