CMS Price Transparency Data

Culture, blood

Facility: Hialeah Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $11
  • Cash Discount Price: $1,134
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Hialeah Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,134. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$1,134

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $1,134 (10988%)
Insurance Median: $11 (107%)
Cash: $1,134 (10988% of Medicare)
Ins. Median: $11 (107% 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 - $333 48%
Humana $5 - $519 48%
Medicaid / KanCare $5 48%
UnitedHealthcare $5 - $10 48%
Veterans Administration Mill Bill $7 68%
Avmed Broad Network $8 78%
Medicare (plans) $9 - $22 87%
Aetna $10 - $816 97%
Bristol Hospice- Miami Dade Llc $10 97%
Catholic Hospice $10 97%
Comprehensive Home Health Care Dba Opuscare Of South Florida $10 97%
Devoted Health $10 97%
Employer Direct Healthcare $10 - $13 97%
Hcr Manor Care Services Of Fl $10 97%
Hospice Other $10 97%
Leon Health Inc $10 97%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $10 97%
Seasons Hospice And Pallative Care Of Southern Florida Inc $10 97%
Tricare $10 97%
Veterans Administration Vaccn $10 97%
Vitas Healthcare Hospice Corporation Of Fl $10 97%
Vitas Hospice Unit Agreement $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%
Self Pay/Uninsured $13 126%
Naphcare Inc $14 136%
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 $140 1357%
Bc/Bs Of Fl Health Options Hmo $151 1463%
Bc/Bs Of Fl Simplyblue $151 1463%
Bc/Bs Of Fl Network Blue $163 1579%
Bc/Bs Of Fl Ppo $163 1579%
Bc/Bs Of Fl Blue Select Exchange Non Par $173 1676%
Bc/Bs Of Fl Miami Dade Blue Select $173 1676%
Bc/Bs Of Fl Phs $588 5698%
Dimensions International $737 7141%
First Health $771 7471%
Dimension Health Ppo $850 8236%
Commercial Non-Contracted $1,134 10988%
Self Pay - Mcd Pending 100 Percent $1,134 10988%
Single Case Agreement $1,134 10988%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals