CMS Price Transparency Data

Culture, blood

Facility: Halifax Health Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $182
  • Cash Discount Price: $290
  • vs. Medicare Baseline: 17.64x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Halifax Health Medical Center is $182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $290. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 17.64x the Medicare baseline. Located in 303 N Clyde Morris Blvd, Daytona Beach, FL.
Cash / Self-Pay
$290

Average discount available for prompt cash payment at this facility.

Insurance Median
$182

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: $290 (2810%)
Insurance Median: $182 (1764%)
Cash: $290 (2810% of Medicare)
Ins. Median: $182 (1764% 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 1764% of the Medicare baseline (a markup of 1664%). 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
Aetna $5 - $363 48%
Coventry $5 - $229 48%
Hcra $5 48%
Humana $5 48%
Independent Living Systems $5 - $182 48%
Medicaid / KanCare $5 48%
Molina $5 48%
Simply Healthcare Plans $5 48%
Sunshine State Health Plan $5 - $127 48%
UnitedHealthcare $5 - $218 48%
West Volusia $5 48%
Caresource Network $6 58%
Employers Health Network $15 145%
Fhcp $21 203%
Florida Healthcare $22 213%
Embs $102 - $309 988%
Florida Healthcare - Hecn $124 1202%
Blue Cross Blue Shield $142 - $160 1376%
Avmed $167 - $182 1618%
Centivo $182 1764%
County Of Volusia Corrections $182 1764%
A&G Admin $185 1793%
Volusia County Employee $185 1793%
Claimdoc $218 2112%
Devoted Health $218 2112%
Division Of The Blind $218 2112%
Oscar $218 2112%
Prime Health Services $218 2112%
Volusia $218 - $254 2112%
Sim Plan Pay $236 2287%
Hrgi $254 2461%
Plotkin Consulting $254 2461%
Evolutions International $272 2636%
Summit America $290 2810%
Americas Choice Provider Network $327 - $363 3169%
Integrated Health Plan $327 3169%
Multiplan $327 3169%
Three Rivers $345 3343%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals