CMS Price Transparency Data

Culture, blood

Facility: Bellevue Hospital Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $31
Cash Discount Price: $10
vs. Medicare Baseline: 3.00x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Bellevue Hospital Center is $31. 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 3.00x the Medicare baseline. Located in 462 First Avenue, New York, NY.

Cash / Self-Pay

$10

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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: $31 (300%)

Cash: $10 (97% of Medicare)

Ins. Median: $31 (300% 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 300% of the Medicare baseline (a markup of 200%). 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
Aetna	$6 - $26	58%
Healthfirst	$7 - $106	68%
Blue Cross Blue Shield	$8 - $106	78%
Centerlight	$10 - $13	97%
Elderplan	$10	97%
Fidelis	$10 - $106	97%
Hamaspik	$10 - $13	97%
Metroplus	$10 - $106	97%
Centers Plan For Healthy Living	$11	107%
Oxford	$11 - $15	107%
Wellcare	$11 - $16	107%
Magnacare	$12	116%
Villagecare Max	$12 - $31	116%
Local 1199	$13 - $31	126%
Oscar	$14 - $15	136%
United	$15 - $59	145%
Affinity	$18 - $106	174%
Carelon	$24 - $47	233%
Cigna	$26	252%
Emblem	$26 - $64	252%
Multiplan	$29	281%
Vnsny	$31 - $48	300%
Amidacare	$47	455%
Senior Whole Health	$47	455%
United Behavioral Health	$47 - $52	455%
Carelon (Amida Care)	$48	465%

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 $10.
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 Bellevue Hospital Center 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.