CMS Price Transparency Data

Culture, blood

Facility: Baptist Medical Center Beaches

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $164
  • Cash Discount Price: $317
  • vs. Medicare Baseline: 15.89x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Baptist Medical Center Beaches is $164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $317. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 15.89x the Medicare baseline. Located in 1350 13Th Ave S, Jacksonville Beach, FL.
Cash / Self-Pay
$317

Average discount available for prompt cash payment at this facility.

Insurance Median
$164

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: $317 (3072%)
Insurance Median: $164 (1589%)
Cash: $317 (3072% of Medicare)
Ins. Median: $164 (1589% 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 1589% of the Medicare baseline (a markup of 1489%). 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
Amerigroup Of Georgia $4 39%
Daniel Memorial $4 39%
Simply Healthcare Plans $4 - $5 39%
Simply Healthcare Plans - Cha $4 39%
Sunshine State Health Plan $4 39%
Aetna $5 - $409 48%
Amerihealth Caritas $5 48%
Florida Community Care $5 - $11 48%
Molina Healthcare Of Florida $5 48%
United Community Plan $5 48%
Vivida Health $5 48%
Community Hospice Of Northeast Florida $10 97%
Pace $10 97%
Tomorrow'S Rainbow $10 97%
UnitedHealthcare $10 - $268 97%
Va Ccn $10 97%
Devoted $11 107%
Upmc $11 107%
Ambetter / Centene $25 242%
Blue Cross Blue Shield $102 - $332 988%
Avmed $164 - $261 1589%
Borland Groover $204 1977%
Occunet $204 1977%
Cigna $215 - $312 2083%
Northeast Florida State Hospital $215 2083%
Centivo $225 - $434 2180%
Capital Health Plan $235 2277%
Geo Group $256 2481%
Watchtower $281 2723%
Fscj Student Insurance $307 2975%
Suddath Company $322 3120%
Caresource Of Georgia $332 3217%
Medicaid / KanCare $332 3217%
Peach State Health Plan $332 3217%
Phcs $383 3711%
Evolutions Healthcare $460 4457%
Multiplan $460 4457%
Corvel $501 4855%
Coventry Workers Comp $501 4855%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1350 13Th Ave S, Jacksonville Beach, FL 32250
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals