CMS Price Transparency Data

Culture, blood

Facility: West Kendall Baptist Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $408
  • Cash Discount Price: $698
  • vs. Medicare Baseline: 39.53x Medicare
The contracted insurance negotiated median rate for a Culture, blood at West Kendall Baptist Hospital is $408. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $698. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 39.53x the Medicare baseline. Located in 9555 Sw 162 Ave, Miami, FL.
Cash / Self-Pay
$698

Average discount available for prompt cash payment at this facility.

Insurance Median
$408

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: $698 (6764%)
Insurance Median: $408 (3953%)
Cash: $698 (6764% of Medicare)
Ins. Median: $408 (3953% 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 3953% of the Medicare baseline (a markup of 3853%). 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
Aetna $5 - $859 48%
Amerigroup $5 48%
Medicaid / KanCare $5 - $6 48%
Sunshine State $5 48%
UnitedHealthcare $5 - $1,074 48%
Vista $5 48%
Wellcare $5 48%
Medicare (plans) $10 - $14 97%
Avmed $11 - $523 107%
Blue Cross Blue Shield $11 - $696 107%
Humana $11 107%
Medica Health Plan $11 107%
Cigna $12 - $859 116%
Leon Medical $12 116%
Non Contracted $394 3818%
Amerihealth $483 4680%
International $698 6764%
Dimension Health Plan $806 - $967 7810%
Affordable $967 9370%
Phcs $967 9370%
Quality Health $967 9370%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9555 Sw 162 Ave, Miami, FL 33196
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals