CMS Price Transparency Data

Culture, blood

Facility: Doctors Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $11
  • Cash Discount Price: $319
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Doctors Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $319. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 3651 Wheeler Road, Augusta, GA.
Cash / Self-Pay
$319

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $319 (3091%)
Insurance Median: $11 (107%)
Cash: $319 (3091% of Medicare)
Ins. Median: $11 (107% 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 $9 - $176 87%
Blue Cross Blue Shield $9 - $11 87%
Humana $9 - $10 87%
Devoted Health $10 97%
Friday Health $10 97%
Health Net $10 97%
Healthspring $10 97%
Regency Hospice $10 97%
St Joseph Hospice $10 97%
United $10 - $143 97%
Absolute Total Care $11 - $57 107%
Caresource $11 107%
Clover $11 107%
Coventry $11 107%
Eon Health $11 107%
Georgia Assurance $11 107%
Shared Health $11 107%
Wellcare $11 - $64 107%
Health One Alliance $12 116%
Qtc Medical Group $12 116%
Blue Choice $13 126%
Ambetter / Centene $14 136%
Dept Of Community Health $15 145%
Amerigroup $45 436%
Nhc Advantage $61 591%
Pruitt Health $61 591%
Peach State $64 620%
Centurion $88 853%
Americas 1St Choice $89 862%
Medcost $160 - $204 1550%
Kaiser Permanente $174 1686%
Multiplan $191 - $287 1851%
Performax $217 2103%
First Health $239 2316%
Employer'S Health Network $255 2471%
Novanet $287 2781%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3651 Wheeler Road, Augusta, GA 30909
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals