CMS Price Transparency Data

Culture, blood

Facility: Cambridge Health Alliance

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $79
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 7.66x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Cambridge Health Alliance is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 7.66x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$79

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: $79 (766%)
Insurance Median: $79 (766%)
Cash: $79 (766% of Medicare)
Ins. Median: $79 (766% 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 766% of the Medicare baseline (a markup of 666%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Boston Medical Center - Wellsense [50003] $9 87%
Fallon [50006] $9 87%
Mass Bh Partnership [70098] $9 87%
Mass General Brigham [50021] $9 - $50 87%
Mass Health [70001] $9 87%
Medicaid / KanCare $9 87%
Other Tufts Health Public Plan [75002] $9 - $17 87%
Tufts Together W Cha [75001] $9 87%
UnitedHealthcare $9 - $33 87%
Medicare (plans) $10 - $79 97%
Aarp [40001] $14 136%
Oxford Health [40004] $14 136%
United Medical Resource [40005] $14 136%
Wc [90001] $14 136%
Blue Cross Blue Shield $20 - $79 194%
Wellpoint [50012] $21 203%
Aetna $27 - $79 262%
Cigna $30 - $79 291%
Tufts Health Plan [30001] $30 - $34 291%
Health Plans Inc [20002] $33 320%
Hphc [20001] $33 320%
Multiplan [50010] $54 523%
Altus Dental [99011] $79 766%
Beacon Health Strategies [50002] $79 766%
Cbhc Uninsured Crisis Alt Payer [70097] $79 766%
Cbhc Uninsured Crisis [70096] $79 766%
Celticare [50004] $79 766%
Commonwealth Care Alliance Dental [99004] $79 766%
Coverage Discovery [90004] $79 766%
Delta Dental Of Ma [99007] $79 766%
Dominion National Dental [99012] $79 766%
Dph Tb Payor [85004] $79 766%
Esp Dental [99003] $79 766%
Eyemed Alt Payor [13001] $79 766%
First Health [50007] $79 766%
Global Medical Management [50024] $79 766%
Government Employee Health Association [50023] $79 766%
Guardian Dental [99013] $79 766%
Health Safety Net Dental [99002] $79 766%
Humana $79 766%
Ma Laborers Health And Welfare Fund [50022] $79 766%
Magellan Health Services [65098] $79 766%
Mass Health Dental [99001] $79 766%
Medical Mutual Of Ohio [50019] $79 766%
Metlife Dental [99008] $79 766%
Modern Assistance Program [30098] $79 766%
Mva [90002] $79 766%
Neighborhood Health Plan [50011] $79 766%
Other Bh Payor [50014] $79 766%
Other Commercial Payor [50015] $79 766%
Other Dental Payor [99014] $79 766%
Other Dual Eligible Payer [65004] $79 766%
Other Gov'T Alt [85006] $79 766%
Other Vision Payor [50013] $79 766%
Ri Neighborhood Health Plan [50017] $79 766%
Tricare $79 766%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1493 Cambridge Street, Cambridge, MA 02139
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals