CMS Price Transparency Data

Culture, blood

Facility: Palmetto General Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $10
  • Cash Discount Price: $11
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Palmetto General Hospital is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 0.97x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$11

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $11 (107%)
Insurance Median: $10 (97%)
Cash: $11 (107% of Medicare)
Ins. Median: $10 (97% 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
Bc/Bs Myblue Hmo Hix $2 19%
Bc/Bs Of Fl Blue Select Exchange Non Par $2 19%
Bc/Bs Of Fl Health Options Hmo $2 19%
Bc/Bs Of Fl Miami Dade Blue Select $2 19%
Bc/Bs Of Fl Network Blue $2 19%
Bc/Bs Of Fl Ppo $2 19%
Bc/Bs Of Fl Simplyblue $2 19%
Cigna $2 - $5 19%
Humana $4 - $10 39%
Bc/Bs Of Fl Phs $5 48%
Liga Contra El Cancer $5 48%
Medicaid / KanCare $5 - $11 48%
UnitedHealthcare $5 - $10 48%
Aetna $6 - $11 58%
Magellan Behavioral Health $6 58%
Dimensions International $7 68%
First Health $7 68%
Veterans Administration Mill Bill $7 68%
Dimension Health Ppo $8 78%
Avmed Broad Network $9 87%
Medicare (plans) $9 - $22 87%
Bristol Hospice- Miami Dade Llc $10 97%
Catholic Hospice $10 97%
Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc $10 97%
Devoted Health $10 97%
Employer Direct Healthcare $10 - $11 97%
Healthsun Health Plans $10 - $11 97%
Hospice Other $10 97%
Ima Evalutations Inc $10 97%
Leon Health Inc $10 97%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $10 97%
Opuscare Of South Fl $10 97%
Seasons Hospice And Pallative Care Of Southern Florida Inc $10 97%
Select Specialty Hospital $10 97%
Tricare $10 97%
Veterans Administration Vaccn $10 97%
Vitas Healthcare Hospice $10 97%
Westchester General Hospital $10 97%
Beacon Health Strategies Commercial $11 107%
Commercial Non-Contracted $11 107%
Longevity Health Plan $11 107%
Self Pay - Mcd Pending 100 Percent $11 107%
Single Case Agreement $11 107%
United Behavioral Health Psych $11 107%
Bright Health Management Commercial $12 116%
Dimension Health Wc $12 116%
Florida Pace Centers $12 116%
Imagine Health $12 116%
Oscar Health Plan Hix $12 116%
Workers Compensation $12 116%
Self Pay/Uninsured $13 126%
Naphcare Inc $14 136%
Avmed Exchange $18 174%
Ambetter / Centene $19 184%
Molina Marketplace Program Exchange $20 194%
Auto Insurance $21 203%
Avmed Select Network $21 203%
Amerihealth Caritas Next Exchange $22 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2001 W 68Th St, Hialeah, FL 33016
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals