CMS Price Transparency Data

Culture, blood

Facility: Ascension Providence

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $10
  • Cash Discount Price: $116
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Ascension Providence is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 0.97x the Medicare baseline. Located in 6901 Medical Parkway, Waco, TX.
Cash / Self-Pay
$116

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $116 (1124%)
Insurance Median: $10 (97%)
Cash: $116 (1124% of Medicare)
Ins. Median: $10 (97% 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 $7 - $46 68%
Mclennan County Indigent $7 68%
Medicaid / KanCare $7 - $9 68%
Superior Chip/Chip Perinate $7 - $9 68%
Superior Star $7 - $9 68%
Superior Star Plus $7 - $9 68%
Swhp Rightcare Star $7 - $9 68%
UnitedHealthcare $7 - $11 68%
Wellpoint Star $7 - $9 68%
Medicare (plans) $10 - $11 97%
Tricare $10 97%
Va $10 97%
Aetna $11 107%
Smarthealth $14 136%
Ambetter / Centene $15 145%
Green Imaging $15 145%
Firstcare Focus Network $22 213%
Firstcare Hmo $25 242%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6901 Medical Parkway, Waco, TX 76712
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals