CMS Price Transparency Data

Culture, blood

Facility: Alta Vista Regional Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $136
Cash Discount Price: $150
vs. Medicare Baseline: 13.18x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Alta Vista Regional Hospital is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 13.18x the Medicare baseline. Located in 104 Legion Drive, Las Vegas, NM.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$136

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: $150 (1453%)

Insurance Median: $136 (1318%)

Cash: $150 (1453% of Medicare)

Ins. Median: $136 (1318% 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 1318% of the Medicare baseline (a markup of 1218%). 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
Medicare (plans)	$10 - $300	97%
UnitedHealthcare	$10 - $48	97%
Workers Comp	$10 - $300	97%
Commercial Hmo Ppo	$11 - $300	107%
Medicaid / KanCare	$11 - $300	107%
Champus	$12 - $300	116%
Php Centennial	$14	136%
Mcare Mcaid Hmo Dual	$48	465%
Self Pay	$150	1453%
Other Covernment	$187 - $300	1812%
Blue Cross Blue Shield	$225 - $300	2180%
Mva	$300	2907%
Other Government	$300	2907%

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 $150.
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 Alta Vista Regional 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.