CMS Price Transparency Data

Culture, blood

Facility: Medical Center of McKinney

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $15
  • Cash Discount Price: $570
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Medical Center of McKinney is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $570. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.45x the Medicare baseline. Located in 4500 Medical Center Drive, McKinney, TX.
Cash / Self-Pay
$570

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: $570 (5523%)
Insurance Median: $15 (145%)
Cash: $570 (5523% 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
Aetna $9 - $415 87%
Amerigroup $9 - $10 87%
Cigna $9 - $456 87%
Parkland Community Health Plan $9 87%
United $9 - $107 87%
Blue Cross Blue Shield $10 - $253 97%
Care N Care $10 97%
Devoted Health $10 97%
Humana $10 - $371 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 - $40 107%
Texas Independent Health Plan $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 - $456 194%
Molina Healthcare $27 262%
Oscar $27 262%
Healthcare Highways $140 - $193 1357%
Evry Health $147 1424%
Unicare $148 - $570 1434%
City Of Mckinney $200 1938%
Fidelis Securecare $257 2490%
National Choicecare $285 2762%
Pc Texas Partners $314 3043%
Physicians Coop Of Tx $314 3043%
Rockport Health Group $314 3043%
Averde Health, Inc $331 3207%
Magellan Bh $342 3314%
Value Options Behavioral Health $342 3314%
Coastal Comp Health Networks $399 3866%
Mega Life $399 3866%
Multiplan Phcs $399 3866%
Lewisville Isd/Dls Consulting $428 4147%
Compsych Corporation $456 4419%
Healthsmart Preferred Care $456 4419%
Galaxy Health Network $485 4700%
Independent Medical Systems $570 5523%
National Healthcare Solutions $570 5523%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4500 Medical Center Drive, McKinney, TX 75069
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals