CMS Price Transparency Data

Culture, blood

Facility: HCA Florida Highlands Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $16
  • Cash Discount Price: $606
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Culture, blood at HCA Florida Highlands Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $606. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.55x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
$606

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $606 (5872%)
Insurance Median: $16 (155%)
Cash: $606 (5872% of Medicare)
Ins. Median: $16 (155% 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
Devoted Health $10 97%
Humana $10 - $242 97%
Ndms Definitive Care $10 97%
United $10 - $273 97%
Wellmed $10 97%
Aetna $11 - $182 107%
American Health Plan $11 107%
Blue Cross Blue Shield $11 107%
Centurion $11 107%
Cigna $11 107%
Florida Complete Care $11 107%
Prominence Healthfirst $11 107%
Sunshine State $11 107%
Amerihealth Caritas $12 116%
Longevity Health Plan $12 116%
Oscar $20 194%
Simply Healthcare $23 223%
Freedom Health $52 504%
Avmed $79 - $303 766%
Molina $115 1114%
Office Of Sheiff Highland Co $212 2054%
Prime Health $230 2229%
United Ppo $267 2587%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals