CMS Price Transparency Data

Culture, blood

Facility: Artesia General Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $80
Cash Discount Price: $121
vs. Medicare Baseline: 7.75x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Artesia General Hospital is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 7.75x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$121

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $121 (1172%)

Insurance Median: $80 (775%)

Cash: $121 (1172% of Medicare)

Ins. Median: $80 (775% 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 775% of the Medicare baseline (a markup of 675%). 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
Zelis	$9 - $80	87%
Blue Cross Blue Shield	$10 - $121	97%
Geha	$10 - $161	97%
Humana	$10 - $11	97%
Molina Healthcare Of New Mexico	$10 - $17	97%
Presbyterian Health Plan	$10 - $17	97%
Triwest	$10	97%
UnitedHealthcare	$10 - $171	97%
Vistacare Hospice	$10	97%
First Health	$17 - $181	165%
New Mexico Health Connections	$18	174%
Providence Risk & Insurance Services	$21 - $191	203%
Omni Networks	$141	1366%
Three Rivers Provider Network	$151	1463%
Cigna	$171 - $181	1657%
Galaxy Health	$181	1754%
One Health Plan	$181	1754%
Multiplan	$183	1773%
United Payors & United Providers	$187	1812%

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 $121.
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 Artesia General 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.