CMS Price Transparency Data

Culture, blood

Facility: Medical City North Hills

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $15
  • Cash Discount Price: $592
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Medical City North Hills is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $592. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.45x the Medicare baseline. Located in 4401 Booth Calloway Road, North Richland Hills, TX.
Cash / Self-Pay
$592

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $592 (5736%)
Insurance Median: $15 (145%)
Cash: $592 (5736% of Medicare)
Ins. Median: $15 (145% 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
Cook Childrens Health Plan $6 58%
Aetna $9 - $431 87%
Amerigroup $9 - $10 87%
Cigna $9 - $474 87%
Parkland Community Health Plan $9 87%
United $9 - $127 87%
Blue Cross Blue Shield $10 - $263 97%
Care N Care $10 97%
Devoted Health $10 97%
Humana $10 - $115 97%
Molina $10 - $11 97%
Mutual Of Omaha $10 97%
Triwest Veterans $10 97%
Wellmed $10 97%
American Health Plan Of Texas, Inc. $11 107%
Cenpatico $11 107%
Imperial Insurance Company $11 107%
Integranet $11 107%
Procare Advantge $11 107%
Provider Partners Health Plan $11 107%
Superior Health Plan $11 - $41 107%
Texas Independent Health Plan $11 107%
Triwest Health Alliance $11 107%
Wellcare $11 107%
Universal Healthcare Group $12 116%
Verda Health Plan $13 126%
Bravo Health $15 145%
Superior $18 - $23 174%
Corvel Corporation $20 194%
Usa Managed Care $20 - $474 194%
Molina Healthcare $27 262%
Oscar $27 262%
Unicare $124 - $592 1202%
Healthcare Highways $145 - $200 1405%
Evry Health $153 1483%
City Of Mckinney $267 2587%
Fidelis Securecare $267 2587%
National Choicecare $296 2868%
Pc Texas Partners $326 3159%
Physicians Coop Of Tx $326 3159%
Rockport Health Group $326 3159%
Averde Health, Inc $344 3333%
Magellan Behavior Health $355 3440%
Coastal Comp Health Networks $415 4021%
Mega Life $415 4021%
Multiplan Phcs $415 4021%
Healthsmart Preferred Care $444 4302%
Lewisville Isd/Dls Consulting $444 4302%
Usc Health Services $474 4593%
Galaxy Health Network $504 4884%
Independent Medical Systems $592 5736%
National Healthcare Solutions $592 5736%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4401 Booth Calloway Road, North Richland Hills, TX 76180
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals