CMS Price Transparency Data

Culture, blood

Facility: Sarasota Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $14
Cash Discount Price: $112
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Sarasota Memorial Hospital is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.36x the Medicare baseline. Located in 1700 S Tamiami Trl, Sarasota, FL.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $112 (1085%)

Insurance Median: $14 (136%)

Cash: $112 (1085% of Medicare)

Ins. Median: $14 (136% 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.

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
Amerihealth Caritas Oncology	$1 - $5	10%
Community Care Plan Oncology	$1 - $5	10%
Molina Oncology	$1 - $5	10%
Simply Healthcare Oncology	$1 - $5	10%
Sunshine State Oncology	$1 - $5	10%
Florida Community Care Oncology	$2 - $12	19%
Simply Healthcare	$4	39%
Sunshine State	$4	39%
Amerihealth Caritas	$5	48%
Community Care Plan	$5	48%
Florida Community Care	$5 - $11	48%
Molina	$5	48%
UnitedHealthcare	$6 - $279	58%
Blue Cross Blue Shield	$10 - $18	97%
Aetna	$11 - $298	107%
Simply Freedom Optimum	$11	107%
Simply Freedom Optimum Oncology	$11	107%
Wellcare	$11	107%
Wellcare Oncology	$11	107%
Oscar Oncology	$17	165%
Ambetter / Centene	$28	271%
Avmed	$106 - $272	1027%
Usa Managed Care	$116 - $298	1124%
First Health	$120 - $309	1163%
Careworks	$142 - $272	1376%
Enlyte	$142 - $272	1376%

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 $112.
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 Sarasota Memorial 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.