CMS Price Transparency Data

Culture, blood

Facility: HCA Florida South Shore Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $64
  • Cash Discount Price: $2,416
  • vs. Medicare Baseline: 6.20x Medicare
The contracted insurance negotiated median rate for a Culture, blood at HCA Florida South Shore Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,416. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 6.20x the Medicare baseline. Located in 4016 Sun City Center Blvd, Sun City Center, FL.
Cash / Self-Pay
$2,416

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $2,416 (23411%)
Insurance Median: $64 (620%)
Cash: $2,416 (23411% of Medicare)
Ins. Median: $64 (620% 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 620% of the Medicare baseline (a markup of 520%). 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 - $677 87%
Aetna $10 - $725 97%
Caresource $10 97%
Devoted Health $10 97%
Ndms Definitive Care $10 97%
United $10 - $1,087 97%
United Va Ccn $10 97%
Wellmed $10 97%
Align Senior Care $11 107%
American Health Plan $11 107%
Baycare Health Plans $11 107%
Blue Cross Blue Shield $11 107%
Centurion $11 107%
Cigna $11 107%
Clear Spring Health $11 107%
Florida Complete Care $11 107%
Gold Kidney Of Florida $11 107%
Secur $11 107%
Sunshine State $11 107%
Ultimate Health Plan $11 107%
Wellcare $11 107%
Careplus $12 116%
Longevity Health Plan $12 116%
Simply Healthcare $12 - $372 116%
Oscar $14 136%
Solis Health Plan $15 145%
Access 2 Healthcare Physicians Freedom Optimum Group Members $114 1105%
Access 2 Healthcare Physicians Freedom Health $174 1686%
Access 2 Healthcare Physicians Optimum $174 1686%
Freedom Health Care $188 1822%
Optimum Healthcare $188 1822%
Avmed $193 - $604 1870%
Corvel Corporation $250 2422%
Rockport Healthcare Group $250 2422%
Prime Health $255 2471%
Molina $459 - $652 4448%
Evolutions Healthcare Systems $556 - $2,223 5388%
Sunshine State Health Plan $616 5969%
Plotkin Health $1,208 11705%
Prime Health Sheriff $1,208 11705%
Multiplan $1,812 - $2,054 17558%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4016 Sun City Center Blvd, Sun City Center, FL 33573
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals