CMS Price Transparency Data

Culture, blood

Facility: Larkin Community Hospital Palm Springs Campus

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $126
  • Cash Discount Price: $361
  • vs. Medicare Baseline: 12.21x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Larkin Community Hospital Palm Springs Campus is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $361. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 12.21x the Medicare baseline. Located in 1475 W 49Th St, Hialeah, FL.
Cash / Self-Pay
$361

Average discount available for prompt cash payment at this facility.

Insurance Median
$126

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: $361 (3498%)
Insurance Median: $126 (1221%)
Cash: $361 (3498% of Medicare)
Ins. Median: $126 (1221% 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 1221% of the Medicare baseline (a markup of 1121%). 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 $4 - $10 39%
Florida Community Care Mcaid-All Plans $4 39%
Miami Childrens Hp Mcaid-All Plans $4 39%
Sunshine Mcaid $4 39%
Wellcare Mcaid $4 39%
Simply Healthcare Mcaid $5 48%
United Mcaid $5 48%
Ambetter / Centene $10 97%
Blue Cross Blue Shield $10 - $172 97%
Fdc - All Plans $10 97%
Medicare (plans) $10 - $516 97%
Opus Hospice Ip Only - All Plans $10 97%
Clear Springs Health - All Plans $11 107%
Unicare Simply Mcare Ppo - All Plans $11 107%
Bright Health Commercial - All Other Plans $12 116%
Ccs - All Plans $14 136%
Cigna $129 1250%
Humana $155 - $516 1502%
Wellcare Comm (Choice) - All Other Plans $258 2500%
Leon Med Center Mcr Adv - All Plans $464 4496%
Careplus Health - All Other Plans $516 5000%
Centurion Doc - All Plans $516 5000%
Doctors Healthcare - All Plans $516 5000%
Florida Health Solution/Hmo - All Plans $516 5000%
Preferred Care Partners Mcr - All Plans $516 5000%
Simply Healthcare Mcr - All Other Plans $516 5000%
UnitedHealthcare $516 5000%
Naphcare - All Plans $593 5746%
Oscar Health-All Plans $1,032 10000%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1475 W 49Th St, Hialeah, FL 33012
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals