CMS Price Transparency Data

Culture, blood

Facility: Baptist Hospital of Miami

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $121
Cash Discount Price: $410
vs. Medicare Baseline: 11.72x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Baptist Hospital of Miami is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $410. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 11.72x the Medicare baseline. Located in 8900 N Kendall Dr, Miami, FL.

Cash / Self-Pay

$410

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $410 (3973%)

Insurance Median: $121 (1172%)

Cash: $410 (3973% of Medicare)

Ins. Median: $121 (1172% 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 1172% of the Medicare baseline (a markup of 1072%). 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
Amerigroup	$5	48%
Medicaid / KanCare	$5 - $6	48%
Sunshine State	$5	48%
UnitedHealthcare	$5 - $1,074	48%
Wellcare	$5	48%
Aetna	$6 - $859	58%
Vista	$9	87%
Medicare (plans)	$10 - $14	97%
Avmed	$11 - $528	107%
Blue Cross Blue Shield	$11 - $696	107%
Humana	$11	107%
Medica Health Plan	$11	107%
Cigna	$12 - $859	116%
Leon Medical	$12	116%
Non Contracted	$68 - $394	659%
Amerihealth	$84 - $483	814%
International	$121 - $698	1172%
Dimension Health Plan	$140 - $967	1357%
Affordable	$158 - $913	1531%
Phcs	$167 - $967	1618%
Quality Health	$167 - $967	1618%

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 $410.
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 Baptist Hospital of Miami 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.