CMS Price Transparency Data

Culture, blood

Facility: HCA Florida West Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $25
  • Cash Discount Price: $1,525
  • vs. Medicare Baseline: 2.42x Medicare
The contracted insurance negotiated median rate for a Culture, blood at HCA Florida West Hospital is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,525. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 2.42x the Medicare baseline. Located in 8383 N Davis Hwy, Pensacola, FL.
Cash / Self-Pay
$1,525

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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: $1,525 (14777%)
Insurance Median: $25 (242%)
Cash: $1,525 (14777% of Medicare)
Ins. Median: $25 (242% 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 242% of the Medicare baseline (a markup of 142%). 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
Humana $9 - $305 87%
Ndms Definitive Care $10 97%
Triwest Healthcare Alliance $10 97%
United $10 - $686 97%
United Behavioral Health $10 97%
Value Options $10 97%
Wellmed $10 97%
Aetna $11 - $457 107%
Align Senior Care $11 107%
American Health Plan $11 107%
Blue Cross Blue Shield $11 107%
Centurion $11 107%
Clear Spring Health $11 107%
Florida Complete Care $11 107%
Gold Kidney Of Florida $11 107%
Healthspring Of Florida $11 107%
Sunshine State $11 107%
Wellcare $11 107%
Longevity Health Plan $12 116%
Oscar $12 116%
Ultimate Health Plan $12 116%
Simply Healthcare $16 155%
Naphcare $22 - $25 213%
Seven Corners $22 - $25 213%
Freedom Health $194 1880%
Simply $235 2277%
Corvel Corporation $236 2287%
Prime Health $241 2335%
Careworks (Rockport Community) $249 2413%
Molina Healthcare $290 - $488 2810%
Avmed $366 - $762 3547%
Sunshine State Health Plan $389 3769%
Plotkin Health $762 7384%
Prime Health Sheriff $762 7384%
Evolutions Healthcare $991 - $1,296 9603%
Multiplan $1,189 - $1,296 11521%
Evernorth $1,220 11822%
Ppo Next $1,296 12558%
Novanet $1,372 13295%
Beacon Health Options $1,525 14777%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8383 N Davis Hwy, Pensacola, FL 32514
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals