CMS Price Transparency Data

Culture, blood

Facility: St David's Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $16
  • Cash Discount Price: $319
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Culture, blood at St David's Medical Center is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $319. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.55x the Medicare baseline. Located in 919 E 32Nd St, Austin, TX.
Cash / Self-Pay
$319

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $319 (3091%)
Insurance Median: $16 (155%)
Cash: $319 (3091% of Medicare)
Ins. Median: $16 (155% 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 $9 - $102 87%
St David’S Hospice $9 - $10 87%
United $9 - $144 87%
Aetna $10 - $11 97%
Cigna $10 - $29 97%
Devoted Health $10 97%
Humana $10 - $11 97%
Molina Healthcare $10 - $11 97%
Odyssey Hospice $10 97%
Triwest Healthcare Alliance $10 97%
Triwest Veterans $10 97%
Wellmed $10 97%
American Health Plan Of Texas $11 107%
Imperial Insurance $11 107%
Provider Partners Health Plan $11 107%
Pyramid Life $11 107%
Sendero $11 - $18 107%
Shared Health $11 107%
Superior Health Plan $11 - $54 107%
Texas Independent Health Plan $11 107%
Triwest Health Alliance $11 107%
Wellcare $11 107%
Universal Health $12 116%
Austin Fc $13 126%
Amerigroup $14 136%
Naphcare $16 155%
Seven Corners $16 155%
Corvel Corporation $20 194%
Oscar $28 - $32 271%
Moda $75 727%
Covenant Management Systems $92 891%
Healthcare Highways $93 - $96 901%
Imo Med - Select Network $96 930%
Nomi Health $102 - $118 988%
Moda Health $115 - $118 1114%
Evry Health $117 1134%
Texas Healthcare Foundation Heb $118 1143%
Texas Workforce Commission $124 1202%
Harbor Health Team $128 1240%
Averde Health $144 1395%
Comanche County $160 1550%
National Choicecare $160 1550%
Healthsmart Preferred Care $175 - $255 1696%
Independent Medical Systems $175 1696%
Physicians Cooperative Of Texas $175 1696%
Prime Health $191 1851%
First Health $201 - $229 1948%
Coastal Comp Health Networks $207 2006%
National Health Care $207 2006%
Occunet $223 2161%
Texas Municipal League $223 2161%
Medcorp Southwest $239 2316%
Rockport Healthcare Group $255 - $287 2471%
Bce Emergis Corporation $287 2781%
Beech Street $287 2781%
Medical Control Network Solutions $287 2781%
Multiplan $287 2781%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 919 E 32Nd St, Austin, TX 78705
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals