CMS Price Transparency Data

Culture, blood

Facility: Southern Regional Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $10
  • Cash Discount Price: $10
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Southern Regional Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 0.97x the Medicare baseline. Located in 11 Upper Riverdale Road, Sw, Riverdale, GA.
Cash / Self-Pay
$10

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $10 (97%)
Insurance Median: $10 (97%)
Cash: $10 (97% of Medicare)
Ins. Median: $10 (97% 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.

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 $7 - $10 68%
Americas Choice Provider Network $10 97%
Blue Cross Blue Shield $10 97%
Caresource $10 - $15 97%
Cigna $10 - $18 97%
Clear Spring Health Plan $10 97%
Corvel $10 97%
Georgia Workers’ Compensation $10 97%
Humana $10 - $21 97%
Medicare (plans) $10 97%
Multiplan $10 97%
Novanet $10 97%
Prime Health Services $10 97%
Provider Select $10 97%
Riverwood Behavioral Health $10 - $13 97%
Three Rivers $10 97%
Tricare $10 97%
UnitedHealthcare $10 97%
Devoted Health $11 107%
Peach State $11 - $15 107%
Sonder Health Plan $11 107%
Wellcare $11 - $15 107%
Oscar Health Plan $13 126%
Employer Direct Healthcare $14 136%
Amerihealth Caritas $15 145%
Centurion $15 145%
Medicaid / KanCare $15 145%
Naphcare $16 155%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11 Upper Riverdale Road, Sw, Riverdale, GA 30274
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals