CMS Price Transparency Data

Culture, blood

Facility: HCA Florida Raulerson Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $106
  • Cash Discount Price: $1,228
  • vs. Medicare Baseline: 10.27x Medicare
The contracted insurance negotiated median rate for a Culture, blood at HCA Florida Raulerson Hospital is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,228. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.27x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.
Cash / Self-Pay
$1,228

Average discount available for prompt cash payment at this facility.

Insurance Median
$106

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: $1,228 (11899%)
Insurance Median: $106 (1027%)
Cash: $1,228 (11899% of Medicare)
Ins. Median: $106 (1027% 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 1027% of the Medicare baseline (a markup of 927%). 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
Careplus $10 97%
Devoted Health $10 97%
Humana $10 - $491 97%
Ndms Definitive Care $10 97%
United $10 - $553 97%
Veterans Evaluation Services $10 97%
Wellmed $10 97%
Aetna $11 - $368 107%
American Health Plan $11 107%
Blue Cross Blue Shield $11 107%
Centurion $11 107%
Cigna $11 107%
Florida Complete Care $11 107%
Prominence Healthfirst $11 107%
Sunshine State $11 107%
Ultimate Health Plan $11 107%
Amerihealth Caritas $12 116%
Longevity Health Plan $12 116%
Solis Health Plan $15 145%
Oscar $20 194%
Simply Healthcare $23 223%
Freedom Health $106 - $196 1027%
Optimum $106 1027%
Avmed $160 - $614 1550%
Simply Healthcare Plans $160 1550%
Corvel Corporation $231 2238%
Molina $233 - $332 2258%
Careworks (Rockport) $236 2287%
Prime Health $236 2287%
Health Sun Health Plan $262 2539%
Sunshine State Health Plan $313 3033%
United Ppo $540 5233%
Plotkin Health $614 5950%
Prime Health Sherriff $614 5950%
Multiplan $921 - $1,044 8924%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1796 Hwy 441 North, Okeechobee, FL 34972
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals