CMS Price Transparency Data

Culture, blood

Facility: Medical City Plano

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $15
  • Cash Discount Price: $1,066
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Medical City Plano is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,066. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.45x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
$1,066

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: $1,066 (10329%)
Insurance Median: $15 (145%)
Cash: $1,066 (10329% 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 - $645 87%
Amerigroup $9 - $10 87%
Cigna $9 - $149 87%
United $9 - $185 87%
Blue Cross Blue Shield $10 - $473 97%
Care N Care $10 97%
Devoted Health $10 97%
Humana $10 - $115 97%
Molina $10 - $11 97%
Mutual Of Omaha $10 97%
Parkland Community Health Plan $10 97%
Triwest Veterans $10 97%
Wellmed $10 97%
American Health Plan Of Texas, Inc. $11 107%
Imperial Insurance Company $11 107%
Integranet $11 107%
Procare Advantge $11 107%
Provider Partners Health Plan $11 107%
Superior Health Plan $11 - $75 107%
Texas Independent Health Plan $11 107%
Triwest Health Alliance $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 - $853 194%
Molina Healthcare $27 262%
Oscar $27 262%
Healthcare Highways $261 - $360 2529%
Evry Health $275 2665%
Lifecare Hospitals $320 3101%
Prominence Health Plan $426 4128%
City Of Mckinney $480 4651%
Fidelis Securecare $480 4651%
National Choicecare $533 5165%
Pc Texas Partners $586 5678%
Physicians Coop Of Tx $586 5678%
Rockport Health Group $586 5678%
Averde Health, Inc $618 5988%
Texas Healthcare Foundation Wc $693 6715%
Coastal Comp Health Networks $746 7229%
Mega Life $746 7229%
Multiplan Phcs $746 7229%
Healthsmart Preferred Care $799 7742%
Lewisville Isd/Dls Consulting $799 7742%
Usc Health Services $853 8266%
Galaxy Health Network $906 8779%
Independent Medical Systems $1,066 10329%
National Healthcare Solutions $1,066 10329%
Unicare $1,066 10329%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals