CMS Price Transparency Data

Culture, blood

Facility: HCA Florida Twin Cities Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $248
  • Cash Discount Price: $2,206
  • vs. Medicare Baseline: 24.03x Medicare
The contracted insurance negotiated median rate for a Culture, blood at HCA Florida Twin Cities Hospital is $248. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,206. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 24.03x the Medicare baseline. Located in 2190 Hwy 85 N, Niceville, FL.
Cash / Self-Pay
$2,206

Average discount available for prompt cash payment at this facility.

Insurance Median
$248

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: $2,206 (21376%)
Insurance Median: $248 (2403%)
Cash: $2,206 (21376% of Medicare)
Ins. Median: $248 (2403% 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 2403% of the Medicare baseline (a markup of 2303%). 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
Humana $9 - $838 87%
Ndms Definitive Care $10 97%
Regency Hospice $10 97%
United $10 - $993 97%
Wellmed $10 97%
Aetna $11 - $662 107%
American Health Plan $11 107%
Blue Cross Blue Shield $11 107%
Centurion $11 107%
Clear Spring Health $11 107%
Florida Complete Care $11 107%
Gold Kidney Of Florida $11 107%
Healthspring Of Florida $11 107%
Sunshine State $11 107%
Wellcare $11 107%
Longevity Health Plan $12 116%
Ultimate Health Plan $12 116%
Oscar $14 136%
Simply Healthcare $16 155%
Corvel Corporation $248 2403%
Prime Health $254 2461%
Careworks (Rockport Community) $262 2539%
Simply $340 3295%
Molina Healthcare $419 - $706 4060%
Avmed $529 - $1,103 5126%
Sunshine State Health Plan $563 5455%
Plotkin Health $1,103 10688%
Prime Health Sheriff $1,103 10688%
Evolutions Healthcare $1,434 - $1,875 13895%
Multiplan $1,721 - $1,875 16676%
Ppo Next $1,875 18169%
Novanet $1,985 19234%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2190 Hwy 85 N, Niceville, FL 32578
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals