CMS Price Transparency Data

Culture, blood

Facility: Englewood Hospital and Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $18
  • Cash Discount Price: $13
  • vs. Medicare Baseline: 1.74x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Englewood Hospital and Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.74x the Medicare baseline. Located in 350 Engle St, Englewood, NJ.
Cash / Self-Pay
$13

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $13 (126%)
Insurance Median: $18 (174%)
Cash: $13 (126% of Medicare)
Ins. Median: $18 (174% 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
Oxford_741 $4 39%
UnitedHealthcare $4 - $10 39%
Americhoice_756 $9 87%
Heathnet Federal Services $9 87%
Hip Health Plan $9 - $10 87%
Horizon New Jersey Health - Dsnp $9 - $10 87%
Aetna $10 - $62 97%
Americhoice_732 $10 97%
Amerigroup_758 $10 97%
Amerihealth_766 $10 97%
Blue Cross Blue Shield $10 - $73 97%
Clover_733 $10 97%
Emblem_762 $10 97%
Humana $10 97%
Wellcare_755 $10 97%
Emblem_734 $11 107%
Wellcare_765 $11 107%
Amerigroup_754 $12 116%
Health Care Support_787 $18 174%
Amerihealth_760 $19 184%
Magnacare_768 $38 368%
Magnacare_770 $38 368%
Amerihealth_757 $58 562%
Multiplan $60 - $62 581%
Cigna $68 659%
Horizon $74 - $79 717%
Magnacare_763 $76 736%
Magnacare_769 $76 736%
Qualcare_752 $83 804%
Qualcare $84 814%
Bergen $94 911%
Coventry $94 911%
Magnacare $101 979%
Qualcare_783 $7,783 75417%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 350 Engle St, Englewood, NJ 07631
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals