CMS Price Transparency Data

Culture, blood

Facility: Novant Health Medical Park Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $98
Cash Discount Price: $92
vs. Medicare Baseline: 9.50x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Novant Health Medical Park Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 9.50x the Medicare baseline. Located in 1950 S Hawthorne Rd, Winston-Salem, NC.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $92 (891%)

Insurance Median: $98 (950%)

Cash: $92 (891% of Medicare)

Ins. Median: $98 (950% 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 950% of the Medicare baseline (a markup of 850%). 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	$10 - $111	97%
Humana	$10 - $120	97%
Pace Of The Southern Piedmont	$10	97%
UnitedHealthcare	$10 - $104	97%
Aetna	$11 - $123	107%
Cigna	$11 - $91	107%
Liberty Health	$11	107%
Nc Department Of Public Safety	$21 - $37	203%
Amerihealth	$37	359%
Carolina Complete	$37	359%
Wellcare	$37	359%
Caresource North Carolina	$62	601%
Atlantic Corporation Dba Atlantic Packaging	$87	843%
Plotkin Health	$92	891%
Amps	$100	969%
Medcost	$131 - $145	1269%
Primary Physician Care	$136	1318%
Beechstreet	$139	1347%
Multiplan	$139	1347%
Phcs	$139	1347%
Employers Choice Network	$149	1444%
Three Rivers Provider Network	$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 $92.
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 Novant Health Medical Park Hospital 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.