CMS Price Transparency Data

Culture, blood

Facility: Southern Coos Hospital & Health Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $107
Cash Discount Price: $146
vs. Medicare Baseline: 10.37x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Southern Coos Hospital & Health Center is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.37x the Medicare baseline. Located in 900 11Th Street Se, Bandon, OR.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$107

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: $146 (1415%)

Insurance Median: $107 (1037%)

Cash: $146 (1415% of Medicare)

Ins. Median: $107 (1037% 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 1037% of the Medicare baseline (a markup of 937%). 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
Healthnet - All Plans	$7 - $18	68%
Tricare	$39 - $103	378%
Advanced Health - All Plans	$43 - $112	417%
Aetna	$45 - $160	436%
Atrio Mcr Adv - Allplans	$45 - $117	436%
Confederated Tribes - All Plans	$45 - $117	436%
Moda Mcr Adv	$45 - $117	436%
Pacific Source Mcr Adv	$45 - $117	436%
Cigna	$54 - $140	523%
Moda Health Plan - All Other Plans	$60 - $158	581%
Prov Netwrk Of America - All Plans	$61 - $160	591%
Three Rivers - All Plans	$61 - $160	591%
UnitedHealthcare	$61 - $160	591%
First Choice - All Plans	$62 - $163	601%
Blue Cross Blue Shield	$63 - $165	610%
Multiplan - All Plans	$63 - $165	610%
First Health - All Plans	$64 - $168	620%
Pacific Source - All Other Plans	$64 - $168	620%
Providence Preferred - All Plans	$64 - $168	620%

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 $146.
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 Southern Coos Hospital & Health 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.