CMS Price Transparency Data

Culture, blood

Facility: Atrium Health Floyd Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $164
Cash Discount Price: $302
vs. Medicare Baseline: 15.89x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Atrium Health Floyd Medical Center is $164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $302. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 15.89x the Medicare baseline. Located in 304 Turner McCall Boulevard, Rome, GA.

Cash / Self-Pay

$302

Average discount available for prompt cash payment at this facility.

Insurance Median

$164

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: $302 (2926%)

Insurance Median: $164 (1589%)

Cash: $302 (2926% of Medicare)

Ins. Median: $164 (1589% 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 1589% of the Medicare baseline (a markup of 1489%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$10 - $410	97%
Blue Cross Blue Shield	$10 - $452	97%
Caresource	$10 - $103	97%
Cigna	$10 - $362	97%
Georgia Assurance	$10	97%
Humana	$10 - $392	97%
Occunet	$10	97%
UnitedHealthcare	$10 - $452	97%
Clover	$11	107%
Wellcare	$11	107%
Peach State Health Plan	$13	126%
Alliant Health Plans	$15 - $241	145%
Ambetter / Centene	$15	145%
Amerigroup	$102	988%
Awc Networks	$118	1143%
Oscar Health Plan	$118 - $211	1143%
Beacon	$302	2926%
Evernorth	$302	2926%
Multiplan	$422	4089%
Beech Street	$470	4554%
Private Health Care Systems	$513	4971%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $302.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87040.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Atrium Health Floyd Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87040.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.