CMS Price Transparency Data

Culture, blood

Facility: St Josephs Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $121
Cash Discount Price: $89
vs. Medicare Baseline: 11.72x Medicare

The contracted insurance negotiated median rate for a Culture, blood at St Josephs Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 11.72x the Medicare baseline. Located in 3001 W Martin Luther King Jr Blvd, Tampa, FL.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $89 (862%)

Insurance Median: $121 (1172%)

Cash: $89 (862% of Medicare)

Ins. Median: $121 (1172% 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 1172% of the Medicare baseline (a markup of 1072%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Clear Health Alliance	$4	39%
Freedom Health	$4	39%
Humana	$4 - $13	39%
Molina Healthcare	$4	39%
Simply Healthcare	$4 - $79	39%
Sunshine Health	$4	39%
UnitedHealthcare	$4 - $397	39%
Aetna	$5 - $359	48%
Florida Community Care	$5	48%
Baycareplus	$10	97%
Blue Cross Blue Shield	$10 - $233	97%
Solis Health	$11	107%
Cigna	$12 - $384	116%
Wellcare	$14	136%
Ambetter / Centene	$23 - $441	223%
Molina	$27 - $261	262%
Freedom	$30 - $88	291%
Optimum	$30 - $88	291%
Careplus	$34 - $101	329%
Ultimate Health Plan	$45 - $132	436%
Avmed	$46 - $216	446%
Evolutions	$74 - $410	717%
First Health	$127 - $375	1231%
Multiplan	$134 - $397	1298%
United Behavioral Health	$149 - $441	1444%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $89.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87040.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Josephs Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87040.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.