CMS Price Transparency Data

Culture, blood

Facility: The Medical Center of Southeast Texas

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $14
  • Cash Discount Price: $430
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Culture, blood at The Medical Center of Southeast Texas is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $430. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.36x the Medicare baseline. Located in 2555 Jimmy Johnson Blvd, Port Arthur, TX.
Cash / Self-Pay
$430

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $430 (4167%)
Insurance Median: $14 (136%)
Cash: $430 (4167% of Medicare)
Ins. Median: $14 (136% 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
UnitedHealthcare $6 - $13 58%
Community Health Choice $9 - $12 87%
Community Health Choice Uhrip $9 87%
Harbor Hospice $9 87%
Medicaid / KanCare $9 - $10 87%
Medsolutions $9 87%
Molina Healthcare $9 - $14 87%
Superior Healthplan $9 - $10 87%
Texas Childrens Health Plan $9 87%
Amerigroup $10 - $34 97%
Beacon Health $10 97%
Blue Cross Blue Shield $10 - $178 97%
Caresact $10 97%
Employer Direct Healthcare $10 - $13 97%
Healthspring $10 97%
Hospice $10 97%
Humana $10 - $26 97%
Medicare (plans) $10 97%
Provider Partners Health Plan $10 97%
Rice Land Hospice $10 97%
Selectcare $10 97%
Texas Medical Management Partners $10 - $13 97%
Tihp (Texas Independence Health Plan) $10 97%
Triwest $10 97%
Cccn Pro Advantage $11 107%
Cigna $11 - $301 107%
League Medical Concepts $11 107%
Tricare $11 107%
Wellcare Of Texas $11 107%
Wellpath $11 107%
Corporate Remedies $15 145%
Elap Services $20 194%
Texas Workers Compensation $21 203%
Self Pay Emergent $64 620%
Dept Of Assistive And Rehabilitative Services $215 2083%
Aetna $249 - $284 2413%
Iasis Employees $258 2500%
Magellan Behavioral Health $258 2500%
First Health $301 2917%
Galaxy Health Network $301 2917%
Private Healthcare Systems $301 2917%
Texas Municipal League $301 2917%
Healthsmart $322 3120%
Multiplan $344 3333%
Commercial Non-Contracted $430 4167%
Heart To Heart Hospice $430 4167%
Lifesynch $430 4167%
Mhnet $430 4167%
Self Pay - Mcd Pending 100 Percent $430 4167%
Single Case Agreement $430 4167%
United Behavioral Health $430 4167%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640
  • CMS Rating: ★★★☆☆
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals