CMS Price Transparency Data

Culture, blood

Facility: Surgical Specialty Center of Baton Rouge

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $14
Cash Discount Price: $91
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Surgical Specialty Center of Baton Rouge is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.36x the Medicare baseline. Located in 8080 Bluebonnet Blvd, Baton Rouge, LA.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $91 (882%)

Insurance Median: $14 (136%)

Cash: $91 (882% of Medicare)

Ins. Median: $14 (136% 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.

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
Uhc_Commcoffee	$6	58%
Aetna	$10 - $11	97%
Amerihealth	$10	97%
Blue Cross Blue Shield	$10 - $13	97%
Cigna	$10	97%
Healthy_Blue	$10	97%
Humana	$10 - $16	97%
Lhc	$10	97%
Medadv-Peoples	$10	97%
Medicaid / KanCare	$10	97%
Medicare (plans)	$10	97%
United	$10	97%
UnitedHealthcare	$10	97%
United_Caid	$10	97%
Va	$10	97%
Wellcare	$11	107%
Verity	$12	116%
Lucent	$14	136%
Ambetter / Centene	$19	184%
Workcomp_Saints	$24	233%
Lsufirst	$28	271%
Gilsbar	$59	572%
Multiplan-Pos	$73	707%
Multiplan-Ppo	$73	707%
Ppoplus	$74	717%
Stjude	$79	766%
Bayou-Med	$85	824%
Dma	$85	824%
Lsu	$85	824%
Southern-Univ	$85	824%
Womans_Hosp	$85	824%
Reny	$91	882%
Ehn	$97	940%
Workcomp_3R	$98	950%
Three_Rivers	$103	998%
Workcomp_Strat	$103	998%
Geha	$106	1027%
Workcomp_Fp	$109	1056%
Usa_Mco	$114	1105%

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 $91.
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 Surgical Specialty Center of Baton Rouge 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.