CMS Price Transparency Data

Culture, blood

Facility: Children's Hospital Colorado

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $252
  • Cash Discount Price: $289
  • vs. Medicare Baseline: 24.42x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Children's Hospital Colorado is $252. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $289. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 24.42x the Medicare baseline. Located in 13123 E 16Th Ave, Aurora, CO.
Cash / Self-Pay
$289

Average discount available for prompt cash payment at this facility.

Insurance Median
$252

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: $289 (2800%)
Insurance Median: $252 (2442%)
Cash: $289 (2800% of Medicare)
Ins. Median: $252 (2442% 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 2442% of the Medicare baseline (a markup of 2342%). 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
Ccha Behavioral Health $28 - $61 271%
Integrated Health Plan $42 - $91 407%
Kaiser $95 - $445 921%
Rocky Mountain Health Plan Behavioral Health $112 - $244 1085%
Carelon Behavioral Health $126 - $426 1221%
Denver Health Medical Plan $126 - $457 1221%
UnitedHealthcare $130 - $304 1260%
Presbyterian Health Plan $134 - $347 1298%
Colorado Access $137 - $298 1328%
Colorado Access Behavioral Health $137 - $298 1328%
Blue Cross Blue Shield $146 - $457 1415%
Molina Healthcare Of Nebraska $154 - $335 1492%
Molina Healthcare Of New Mexico $154 - $335 1492%
Peak Health Alliance/Ebms $154 - $365 1492%
Rocky Mountain Health Plan $154 - $396 1492%
Healthy Blue Of Nebraska $162 - $353 1570%
Humana $171 - $426 1657%
Evernorth Behavioral Health $182 - $396 1764%
Interlink National $182 - $457 1764%
Centivo $193 - $420 1870%
Select Health $196 - $426 1899%
Uchealth Plan Administrators $196 - $426 1899%
Cigna $202 - $439 1957%
Aetna $204 - $487 1977%
Department Of Corrections $218 - $475 2112%
Comppsych Behavioral Health $238 - $518 2306%
First Choice Health $238 - $518 2306%
Midlands Choice $238 - $518 2306%
National Preferred Provider Network $238 - $518 2306%
Multiplan $241 - $524 2335%
Cofinity $252 - $548 2442%
First Choice Of The Midwest $252 - $548 2442%
Usa Managed Care Organization $252 - $548 2442%
First Health Network $258 - $560 2500%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13123 E 16Th Ave, Aurora, CO 80045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens