CMS Price Transparency Data

Culture, blood

Facility: Queens Hospital Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $34
  • Cash Discount Price: $10
  • vs. Medicare Baseline: 3.29x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Queens Hospital Center is $34. 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 3.29x the Medicare baseline. Located in 82-68 164Th Street, Jamaica, NY.
Cash / Self-Pay
$10

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $34 (329%)
Cash: $10 (97% of Medicare)
Ins. Median: $34 (329% 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 329% of the Medicare baseline (a markup of 229%). 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
Aetna $6 - $26 58%
Healthfirst $7 - $97 68%
Blue Cross Blue Shield $8 - $97 78%
Elderplan $10 97%
Fidelis $10 - $97 97%
Centers Plan For Healthy Living $11 107%
Magnacare $12 116%
Villagecare Max $12 - $31 116%
Centerlight $13 - $18 126%
Hamaspik $13 126%
Local 1199 $13 - $31 126%
Oscar $14 - $15 136%
Oxford $15 145%
United $15 - $46 145%
Wellcare $16 - $22 155%
Affinity $18 - $97 174%
Carelon $24 - $43 233%
Cigna $26 252%
Emblem $26 - $58 252%
Multiplan $29 281%
Vnsny $31 - $44 300%
Metroplus $42 - $97 407%
Amidacare $43 417%
Senior Whole Health $43 417%
United Behavioral Health $43 - $48 417%
Carelon (Amida Care) $44 426%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 82-68 164Th Street, Jamaica, NY 11432
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals