CMS Price Transparency Data

Culture, blood

Facility: Eastern New Mexico Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $12
  • Cash Discount Price: $6
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Eastern New Mexico Medical Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.16x the Medicare baseline. Located in 405 W Country Club Road, Roswell, NM.
Cash / Self-Pay
$6

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $6 (58%)
Insurance Median: $12 (116%)
Cash: $6 (58% of Medicare)
Ins. Median: $12 (116% 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
Self Pay $4 - $7 39%
Nm Work Comp $7 - $11 68%
Capstar $9 87%
Node Champva $9 87%
Tricare $9 87%
Blue Cross Blue Shield $10 - $13 97%
Medicare (plans) $10 97%
Node Hospice Non Par Agree $10 97%
Node Molina Mcr Adv $10 97%
Node Presbyterian Mcr Adv $10 97%
Node Va $10 97%
Triwest $10 97%
UnitedHealthcare $10 - $14 97%
Veterans Eval Services $10 97%
Humana $11 107%
Node Devoted Health Mcr Adv $11 107%
Node Western Sky Mcr Adv $11 107%
Presbyterian Mcd $12 116%
Zelis Nmmip $12 116%
Cigna $13 126%
Medicaid / KanCare $13 126%
Node Wexford Health $13 126%
Presbyterian Commercial $13 126%
Us Dept Of Labor $13 126%
Firstcare Tx $14 136%
Admar $15 145%
Omni $15 - $18 145%
Aetna $16 155%
Healthsmart $16 155%
Multiplan Primary $16 155%
Multiplan Complementary $17 165%
Zelis $17 165%
Affordable $18 174%
Health Connections $23 223%
Node Molina Health Exchange $28 271%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 405 W Country Club Road, Roswell, NM 88201
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals