CMS Price Transparency Data

Culture, blood

Facility: The Medical Center of Aurora & South Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $32
Cash Discount Price: $1,812
vs. Medicare Baseline: 3.10x Medicare

The contracted insurance negotiated median rate for a Culture, blood at The Medical Center of Aurora & South Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,812. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 3.10x the Medicare baseline. Located in 1501 S Potomac St, Aurora, CO.

Cash / Self-Pay

$1,812

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $1,812 (17558%)

Insurance Median: $32 (310%)

Cash: $1,812 (17558% of Medicare)

Ins. Median: $32 (310% 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 310% of the Medicare baseline (a markup of 210%). 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
Cigna	$6 - $1,160	58%
Aetna	$10 - $957	97%
Blue Cross Blue Shield	$10 - $1,341	97%
Bright Health	$10 - $544	97%
Devoted Health	$10	97%
Humana	$10	97%
Mutual Of Omaha	$10	97%
Rocky Mountain Health	$10	97%
Rocky Mountain Health Plan	$10	97%
Total Longterm Care	$10	97%
Triwest Health Alliance	$10	97%
United	$10 - $815	97%
Delaware Life Insurance	$11	107%
Kaiser	$11 - $643	107%
Wellcare	$11	107%
Vail Health	$275	2665%
Colorado Program For Children With Special Needs	$761	7374%
Western Plains Community Health	$1,178	11415%
Multiplan	$1,268 - $1,631	12287%
Northcare	$1,268	12287%
Physician Health Partners	$1,268	12287%
Pinnacol Workers Comp	$1,359	13169%
Medical Development International	$1,450	14050%
Prime Health	$1,631	15804%

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 $1,812.
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 The Medical Center of Aurora & South 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.