CMS Price Transparency Data

Culture, blood

Facility: Albany Medical Center Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $11
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Albany Medical Center Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $44 (426%)
Insurance Median: $11 (107%)
Cash: $44 (426% of Medicare)
Ins. Median: $11 (107% 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
Blue Cross Blue Shield $6 - $53 58%
Blue Shield Highmark $6 - $21 58%
Cdphp $7 - $53 68%
Fidelis $8 - $200 78%
Medicaid / KanCare $8 78%
Mvp $8 - $24 78%
Blue Shield $10 - $26 97%
Cigna $10 97%
Hamaspik $10 - $56 97%
Medicare (plans) $10 97%
UnitedHealthcare $10 - $267 97%
Aetna $11 - $24 107%
Emblem $11 - $19 107%
Emblem Health Ghi $11 - $20 107%
Mvp Commercial $11 107%
Nascentia $11 107%
Nascentia Health Options $11 107%
Tricare $11 107%
Empire Plan Nyship $12 116%
Magnacare $17 - $267 165%
Multiplan $18 - $284 174%
Emblem_Ghi $19 184%
Mvp Essential Plan $51 494%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43 New Scotland Avenue, Mail Code 34, Albany, NY 12208
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals