CMS Price Transparency Data

Culture, blood

Facility: HCA Houston Healthcare Southeast

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $15
  • Cash Discount Price: $1,714
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Culture, blood at HCA Houston Healthcare Southeast is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,714. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.45x the Medicare baseline. Located in 4000 Spencer Hwy, Pasadena, TX.
Cash / Self-Pay
$1,714

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: $1,714 (16609%)
Insurance Median: $15 (145%)
Cash: $1,714 (16609% 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
Texas Health Network $8 78%
Aetna $9 - $68 87%
Amerigroup $9 - $10 87%
Community Health Choice Mcd $9 87%
Texas Childrens Health Plans $9 - $302 87%
United $9 - $771 87%
Blue Cross Blue Shield $10 - $600 97%
Chc Harris Health $10 97%
Cigna $10 - $1,371 97%
Devoted Health $10 97%
Humana $10 - $138 97%
Kelsey Seybold $10 97%
Molina Healthcare $10 - $22 97%
Oscar $10 - $30 97%
Renaissance Ipa Radiology $10 97%
Triwest Healthcare Alliance $10 97%
Van Lang Ipa $10 97%
Wellmed $10 97%
American Health Plan $11 107%
Christus (Usfhp) $11 107%
Integranet Amerigroup Ipa $11 107%
Molina $11 107%
Procare Advantage $11 107%
Provider Partners Health Plan Of Texas $11 107%
Shared Health $11 107%
Superior Health Plan $11 - $103 107%
Wellcare $11 107%
Kindred Hospital $12 116%
Universal Healthcare Group $12 116%
Verda Health Plan $13 126%
Community Health Choice $15 145%
Superior $15 - $16 145%
Corvel Corporation $20 194%
Omni Healthcare $22 213%
Healthcare Highways $31 300%
Texas Workforce Commission $411 3983%
Evry Health $468 4535%
Imagine Health $600 5814%
Healthsmart Preferred Care $737 - $1,457 7141%
Averde Health $771 7471%
Fidelis Securecare Of Tx $771 7471%
Multiplan $857 - $1,542 8304%
Coventry National First Health $913 8847%
Physicians Cooperative Of Texas $942 9128%
Rockport Workers Comp $942 9128%
Beech Street $1,028 - $1,371 9961%
Independent Medical System $1,028 9961%
National Healthcare Solutions $1,028 9961%
Prime Health Services $1,028 9961%
Southwest Medical $1,028 9961%
Coastal Comp $1,114 10795%
Fiesta Mart, Inc $1,285 12452%
Physicians, Inc $1,457 14118%
Affiliated Ppo $1,542 14942%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4000 Spencer Hwy, Pasadena, TX 77504
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals