CMS Price Transparency Data

Culture, blood

Facility: HCA Florida Lake City Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $23
  • Cash Discount Price: $562
  • vs. Medicare Baseline: 2.23x Medicare
The contracted insurance negotiated median rate for a Culture, blood at HCA Florida Lake City Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $562. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 2.23x the Medicare baseline. Located in 340 Nw Commerce Dr, Lake City, FL.
Cash / Self-Pay
$562

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $562 (5446%)
Insurance Median: $23 (223%)
Cash: $562 (5446% of Medicare)
Ins. Median: $23 (223% 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 223% of the Medicare baseline (a markup of 123%). 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
Avmed $6 - $538 58%
Simply $7 - $166 68%
Hospice Of North Central Fl $9 87%
Humana $9 - $215 87%
Ndms Definitive Care $10 97%
United $10 - $484 97%
Wellmed $10 97%
Aetna $11 - $323 107%
Align Senior Care $11 107%
American Health Plan $11 107%
Blue Cross Blue Shield $11 107%
Centurion $11 107%
Cigna $11 107%
Clear Spring Health $11 107%
Evolutions $11 - $915 107%
Florida Complete Care $11 107%
Gold Kidney Of Florida $11 107%
Sunshine State $11 107%
Wellcare $11 107%
Longevity Health Plan $12 116%
Sunshine State Health Plan $12 - $274 116%
Ultimate Health Plan $12 116%
Oscar $13 126%
Simply Healthcare $13 126%
Molina Healthcare $15 - $344 145%
Plotkin Health $24 - $538 233%
Prime Health Sheriff $24 - $538 233%
Hamilton County Jail $26 - $581 252%
Multiplan $37 - $915 359%
Ppo Next $41 - $915 397%
Novanet $43 - $968 417%
Corvel Corporation $231 2238%
Prime Health $236 2287%
Careworks (Rockport Community) $243 2355%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 340 Nw Commerce Dr, Lake City, FL 32055
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals