CMS Price Transparency Data

Culture, blood

Facility: NYU Langone Hospitals

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $26
  • Cash Discount Price: $12
  • vs. Medicare Baseline: 2.52x Medicare
The contracted insurance negotiated median rate for a Culture, blood at NYU Langone Hospitals is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 2.52x the Medicare baseline. Located in 550 First Avenue, New York, NY.
Cash / Self-Pay
$12

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $12 (116%)
Insurance Median: $26 (252%)
Cash: $12 (116% of Medicare)
Ins. Median: $26 (252% 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 252% of the Medicare baseline (a markup of 152%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Healthfirst $8 - $167 78%
Fidelis $9 - $167 87%
Healthplus $9 - $167 87%
Ghi $10 - $153 97%
Hip $10 - $153 97%
Medicare (plans) $10 97%
Wellcare $10 97%
Centerlight $11 107%
Oxford $11 107%
UnitedHealthcare $11 - $167 107%
1199 $13 126%
Hamaspik $15 145%
Metroplus $15 - $167 145%
Cigna $22 213%
Blue Cross Blue Shield $23 - $29 223%
Aetna $26 - $243 252%
Medicaid / KanCare $30 - $74 291%
Somos $32 - $100 310%
Magnacare $49 - $121 475%
Multiplan $76 - $189 736%
Amida $79 - $82 766%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 550 First Avenue, New York, NY 10016
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals