CMS Price Transparency Data

Culture, blood

Facility: HCA Florida North Florida Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $136
  • Cash Discount Price: $2,912
  • vs. Medicare Baseline: 13.18x Medicare
The contracted insurance negotiated median rate for a Culture, blood at HCA Florida North Florida Hospital is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,912. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 13.18x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.
Cash / Self-Pay
$2,912

Average discount available for prompt cash payment at this facility.

Insurance Median
$136

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: $2,912 (28217%)
Insurance Median: $136 (1318%)
Cash: $2,912 (28217% of Medicare)
Ins. Median: $136 (1318% 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 1318% of the Medicare baseline (a markup of 1218%). 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
Hospice Of North Central Fl $9 87%
Humana $9 - $582 87%
Ndms Definitive Care $10 97%
United $10 - $1,311 97%
United Behavioral Health $10 97%
Wellmed $10 97%
Aetna $11 - $874 107%
Align Senior Care $11 107%
American Health Plan $11 107%
Blue Cross Blue Shield $11 107%
Capital Health Plan $11 107%
Centurion $11 107%
Cigna $11 107%
Clear Spring Health $11 107%
Florida Complete Care $11 107%
Gold Kidney Of Florida $11 107%
Sunshine State $11 107%
Wellcare $11 107%
Longevity Health Plan $12 116%
Ultimate Health Plan $12 116%
Oscar $13 126%
Simply Healthcare $13 126%
Corvel Corporation $260 2519%
Prime Health $265 2568%
Careworks (Rockport Community) $273 2645%
Avmed $349 - $1,456 3382%
Simply $448 4341%
Molina Healthcare $553 - $932 5359%
Evolutions $670 6492%
Sunshine State Health Plan $743 7200%
Plotkin Health $1,456 14109%
Prime Health Sheriff $1,456 14109%
Corizon Phs $1,747 16928%
Multiplan $2,272 - $2,476 22016%
Evernorth $2,330 22578%
Evolutions Healthcare $2,476 23992%
Ppo Next $2,476 23992%
Novanet $2,621 25397%
Beacon Health Options $2,912 28217%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6500 W Newberry Rd, Gainesville, FL 32605
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals