CMS Price Transparency Data

Culture, blood

Facility: Saint Mary's Regional Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $12
  • Cash Discount Price: $10
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Saint Mary's Regional Medical Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.16x the Medicare baseline. Located in 235 W 6Th St, Reno, NV.
Cash / Self-Pay
$10

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: $10 (97%)
Insurance Median: $12 (116%)
Cash: $10 (97% 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
Access To Healthcare Network $2 19%
Blue Cross Blue Shield $7 - $10 68%
Health Plan Of Nevada $7 - $10 68%
Medicaid / KanCare $7 68%
Molina Healthcare Of Nv $7 - $10 68%
Silver Summit $7 - $18 68%
Aetna $10 - $25 97%
Medicare (plans) $10 97%
Saint Mary Health Plan $10 - $12 97%
Sierra $10 97%
Tricare $10 97%
Triwest $10 97%
Alignment $11 107%
UnitedHealthcare $11 - $14 107%
Occunet $12 - $87 116%
Pam $12 116%
Veterans Evaluation Service Ves $13 126%
Employer Direct $14 136%
Home Town Test $14 136%
Naphcare $14 136%
Asserta Health $15 145%
Imperial Insurance Company $15 - $19 145%
Nevada Health Partners $19 184%
6 Degrees $21 203%
Custom Ink $22 213%
Nv Preferred $22 - $23 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 235 W 6Th St, Reno, NV 89503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals