CMS Price Transparency Data

Culture, blood

Facility: Henderson Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $199
Cash Discount Price: $574
vs. Medicare Baseline: 19.28x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Henderson Hospital is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $574. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 19.28x the Medicare baseline. Located in 1050 West Galleria Drive, Henderson, NV.

Cash / Self-Pay

$574

Average discount available for prompt cash payment at this facility.

Insurance Median

$199

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: $574 (5562%)

Insurance Median: $199 (1928%)

Cash: $574 (5562% of Medicare)

Ins. Median: $199 (1928% 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 1928% of the Medicare baseline (a markup of 1828%). 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
Blue Cross Blue Shield	$5 - $7	48%
Molina	$7	68%
Silver_Summit	$7	68%
Smart_Choice	$7	68%
Cigna	$8 - $12	78%
Humana	$10	97%
United_Healthcare	$15	145%
Prominence	$185 - $256	1793%
Sierra_Health_Options	$251 - $303	2432%
Aetna	$410 - $1,083	3973%
Sierra_Health_Plan_Of_Nevada	$418 - $504	4050%
Multiplan	$755 - $911	7316%

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 $574.
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 Henderson 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.