CMS Price Transparency Data

Culture, blood

Facility: HCA Florida Osceola Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $160
  • Cash Discount Price: $2,224
  • vs. Medicare Baseline: 15.50x Medicare
The contracted insurance negotiated median rate for a Culture, blood at HCA Florida Osceola Hospital is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,224. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 15.50x the Medicare baseline. Located in 700 West Oak Street, Kissimmee, FL.
Cash / Self-Pay
$2,224

Average discount available for prompt cash payment at this facility.

Insurance Median
$160

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: $2,224 (21550%)
Insurance Median: $160 (1550%)
Cash: $2,224 (21550% of Medicare)
Ins. Median: $160 (1550% 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 1550% of the Medicare baseline (a markup of 1450%). 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 - $623 87%
Devoted Health $10 97%
Ndms Definitive Care $10 97%
United $10 - $1,001 97%
United Behavioral Health $10 97%
Wellmed $10 97%
Aetna $11 - $667 107%
Align Senior Care $11 107%
American Health Plan $11 107%
Avmed $11 - $1,112 107%
Blue Cross Blue Shield $11 107%
Centurion $11 107%
Cigna $11 107%
Clear Spring Health $11 107%
Fl Health Care Plan $11 107%
Florida Complete Care $11 107%
Gold Kidney Of Florida $11 107%
Sunshine State $11 107%
Wellcare $11 107%
Careplus $12 116%
Longevity Health Plan $12 116%
Ultimate Health Plan $12 116%
Oscar $15 145%
Solis Health Plan $15 145%
Simply Healthcare $16 155%
Freedom Health $160 1550%
Optimum $160 1550%
Corvel Corporation $246 2384%
Prime Health $251 2432%
Careworks (Rockport Community) $259 2510%
Simply $343 3324%
Molina Healthcare $423 - $601 4099%
Evolutions $512 4961%
Sunshine State Health Plan $567 5494%
Plotkin Health $1,112 10775%
Prime Health Sheriff $1,112 10775%
Multiplan $1,668 - $1,891 16163%
Evernorth $1,779 17238%
Ppo Next $1,891 18324%
Novanet $2,002 19399%
Beacon Health Options $2,224 21550%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 700 West Oak Street, Kissimmee, FL 34741
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals