CMS Price Transparency Data

Culture, blood

Facility: Lower Keys Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $17
  • Cash Discount Price: $171
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Lower Keys Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.65x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$171

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $171 (1657%)
Insurance Median: $17 (165%)
Cash: $171 (1657% of Medicare)
Ins. Median: $17 (165% 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.

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
Florida Childrens Medical Services $6 58%
Medicaid / KanCare $6 - $7 58%
South Florida Community Care Network $6 58%
Amerigroup $7 68%
Humana $7 - $10 68%
Molina $7 68%
Positive Healthcare $7 68%
Prestige Health Choice $7 68%
Simply Healthcare $7 - $171 68%
Wellcare $7 68%
Wellcare Healthease $7 68%
Magellan $8 78%
UnitedHealthcare $8 - $425 78%
Blue Cross Blue Shield $10 - $552 97%
Medicare (plans) $10 97%
Node Non Par Hospice Agree $10 97%
Node United Behavioral Va Ccn $10 97%
Node Va $10 97%
Tricare $10 97%
Ultimate Health $10 97%
Veterans Eval Services $10 97%
Correct Care Solutions $11 107%
Node Champva $11 107%
Fl Work Comp $12 116%
Heritage Summit Work Comp Fl $12 116%
Prime Health Work Comp Fl $12 116%
Node Us Dept Of Labor $13 126%
State Auto Insurance Fl $21 203%
Self Pay $149 - $193 1444%
Cigna $326 3159%
Aetna $386 3740%
Monroe County $414 4012%
Evolutions Healthcare Systems $442 - $525 4283%
Keys Energy $442 4283%
Prime Health Ppo $442 4283%
Avmed Health Plan $469 4545%
Direct Healthcare $552 5349%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals