CMS Price Transparency Data

Culture, blood

Facility: Atrium Health Navicent Peach

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $88
Cash Discount Price: $80
vs. Medicare Baseline: 8.53x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Atrium Health Navicent Peach is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 8.53x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $80 (775%)

Insurance Median: $88 (853%)

Cash: $80 (775% of Medicare)

Ins. Median: $88 (853% 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 853% of the Medicare baseline (a markup of 753%). 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
Blue Cross Blue Shield	$13 - $34	126%
Cigna	$22 - $116	213%
Humana	$26 - $136	252%
Securehealth	$26 - $104	252%
Aetna	$29 - $94	281%
Care Source	$34	329%
Clover	$34	329%
Eon Health	$34	329%
Georgia Health Advantage	$34	329%
Pruitt Health	$34	329%
UnitedHealthcare	$34 - $101	329%
Ambetter / Centene	$48 - $82	465%
Alliant	$78	756%
Multiplan	$104 - $128	1008%
Novanet	$128	1240%
Three Rivers Provider Network	$136	1318%
Beechstreet	$149	1444%

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 $80.
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 Navicent Peach 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.