CMS Price Transparency Data

Culture, blood

Facility: North Shore Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $13
  • Cash Discount Price: $880
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Culture, blood at North Shore Medical Center is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $880. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.26x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$880

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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: $880 (8527%)
Insurance Median: $13 (126%)
Cash: $880 (8527% of Medicare)
Ins. Median: $13 (126% 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.

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
Cigna $5 - $440 48%
Humana $5 - $351 48%
Medicaid / KanCare $5 - $880 48%
UnitedHealthcare $5 - $10 48%
Veterans Administration Mill Bill $7 68%
Avmed Broad Network $9 87%
Medicare (plans) $9 - $880 87%
Aetna $10 - $633 97%
Devoted Health $10 97%
Employer Direct Healthcare $10 - $13 97%
Hospice Other $10 97%
Leon Health Inc $10 97%
Tricare $10 97%
Veterans Administration Vaccn $10 97%
Healthsun Health Plans $11 107%
Longevity Health Plan $11 107%
Bright Health Management Commercial $12 116%
Dimension Health Wc $12 116%
Florida Pace Centers $12 116%
Imagine Health $12 116%
Oscar Health Plan Hix $12 116%
Workers Compensation $12 116%
Centurion Prison $13 126%
Self Pay/Uninsured $13 126%
Avmed Exchange $18 174%
Ambetter / Centene $19 184%
Molina Marketplace Program Exchange $20 194%
Auto Insurance $21 203%
Avmed Select Network $21 203%
Amerihealth Caritas Next Exchange $22 213%
Bc/Bs Myblue Hmo Hix $109 1056%
Bc/Bs Of Fl Network Blue $117 1134%
Bc/Bs Of Fl Ppo $117 1134%
Bc/Bs Of Fl Simplyblue $117 1134%
Bc/Bs Of Fl Blue Select Exchange Non Par $126 1221%
Bc/Bs Of Fl Health Options Hmo $126 1221%
Bc/Bs Of Fl Phs $456 4419%
Magellan Behavioral Health $528 5116%
Dimensions International $572 5543%
First Health $598 5795%
Dimension Health Ppo $660 6395%
Beacon Health Strategies Commercial $880 8527%
Commercial Non-Contracted $880 8527%
Self Pay - Mcd Pending 100 Percent $880 8527%
Single Case Agreement $880 8527%
United Behavioral Health Psych $880 8527%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals