CMS Price Transparency Data

Culture, blood

Facility: Boston Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $11
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Boston Medical Center is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.
Cash / Self-Pay
$49

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: $49 (475%)
Insurance Median: $11 (107%)
Cash: $49 (475% 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
Fallon Healthcre Aco [1121] $9 87%
Hlth New England Aco [1123] $9 87%
Mass General Brigham Health Plan Aco [1120] $9 87%
Mass General Brigham Health Plan Mcd Mnged [1107] $9 87%
Medicaid / KanCare $9 87%
Oxford Health [1007] $9 87%
Oxford Health [2024] $9 87%
Tufts Together Aco [1122] $9 87%
Tufts Together Mco [1125] $9 87%
United [2025] $9 - $28 87%
UnitedHealthcare $9 - $10 87%
Wellsense Alli Aco [1118] $9 87%
Wellsense Essential Mco [1101] $9 87%
Zzzunited [1008] $9 - $28 87%
Aetna $10 - $53 97%
Blue Cross Blue Shield $10 - $20 97%
Corrections [9001] $10 - $13 97%
Humana $10 97%
Medicare (plans) $10 - $11 97%
Neighborhood Pace [1206] $10 97%
Tufts [8002] $10 - $28 97%
Ubh Hphc [8016] $10 97%
Veterans Admin [9003] $10 97%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010] $10 97%
Cca [1215] $11 107%
Cigna $11 - $28 107%
Eternalhealth [1227] $11 107%
Fallon Sco [1126] $11 107%
Wellcare [1240] $11 107%
Wellsense [7001] $11 107%
Zzzcca Onecare [1216] $11 107%
Champva [9004] $12 116%
Senior Whole Health [1210] $12 116%
Tricare $12 116%
Fallon [8008] $13 126%
Tufts Conncare/Qhp [8020] $13 - $15 126%
Workers Comp [5002] $14 136%
Zzzbu Employee Work Comp [5004] $14 136%
Zzzcity Of Boston Work Comp [5003] $14 136%
Unicare [8004] $18 174%
Wellpoint [2034] $18 174%
Harvard Pilgrim Health Care [8001] $28 271%
Health Plans Inc [2027] $28 271%
Zzzhealth Plans Inc [1013] $28 271%
Uphams Corner Esp [1213] $44 426%
Meritain Health [1023] $48 465%
Mass General Brigham Health Plan Commercial [8009] $59 572%
Hsn Bad Debt [4003] $513 4971%
Hsn Confidential [4007] $513 4971%
Hsn Dental [4006] $513 4971%
Hsn Partial [4002] $513 4971%
Hsn [4001] $513 4971%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Boston Medical Center Place, Boston, MA 02118
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals