CMS Price Transparency Data

Culture, blood

Facility: HCA Houston Healthcare West

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $12
  • Cash Discount Price: $1,076
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Culture, blood at HCA Houston Healthcare West is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,076. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.16x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
$1,076

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $1,076 (10426%)
Insurance Median: $12 (116%)
Cash: $1,076 (10426% of Medicare)
Ins. Median: $12 (116% 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 - $179 87%
United $9 - $484 87%
Blue Cross Blue Shield $10 - $377 97%
Chc Harris Health $10 97%
Cigna $10 - $861 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 - $65 107%
Triwest Health Alliance $11 107%
Wellcare $11 107%
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 $258 2500%
Evry Health $294 2849%
Imagine Health $377 3653%
Healthsmart Preferred Care $463 - $915 4486%
Averde Health $484 4690%
Fidelis Securecare Of Tx $484 4690%
Coventry National First Health $574 5562%
Physicians Cooperative Of Texas $592 5736%
Rockport Workers Comp $592 5736%
Independent Medical System $646 6260%
National Healthcare Solutions $646 6260%
Southwest Medical $646 6260%
Triumph $646 6260%
Coastal Comp $699 6773%
Multiplan $807 - $915 7820%
Physicians, Inc $915 8866%
Affiliated Ppo $968 9380%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals