CMS Price Transparency Data

Culture, blood

Facility: Quail Creek Surgical Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $61
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 5.91x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Quail Creek Surgical Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 5.91x the Medicare baseline. Located in 6819 Plum Creek, Amarillo, TX.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$61

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: $44 (426%)
Insurance Median: $61 (591%)
Cash: $44 (426% of Medicare)
Ins. Median: $61 (591% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 591% of the Medicare baseline (a markup of 491%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
First Care Commercial [1371] $27 262%
Healthscope Benefits [2290] $29 - $34 281%
UnitedHealthcare $29 - $63 281%
Aetna $34 - $65 329%
Amerigroup Commercial [5055] $34 329%
Black Lung [6055] $34 329%
Caprock Health Plans [1200] $34 329%
Cigna $34 - $63 329%
Curative [7085] $34 329%
Healthcare Highways [2210] $34 329%
Horizon Nj Health [3635] $34 329%
Lucent Health [6000] $34 329%
Medicaid / KanCare $34 329%
Midland Pace Mcaid [3715] $34 329%
Oncology Patient Assistance Programs [2295] $34 329%
Texas Childrens Health Plan [3995] $34 329%
Web Tpa [2115] $34 - $65 329%
Insurance Management Services (Ims) [1540] $39 378%
Group Pension Admin [1450] $44 426%
Sana Benefits [5005] $44 426%
Administrative Concepts [1005] $61 591%
Alieracare [2935] $61 591%
Americas Choice Health Plans [1090] $61 591%
Assurant Health [1105] $61 591%
Beech Street [1170] $61 591%
Benefit Management [1175] $61 591%
Cbsa [1215] $61 591%
Celtic Life [1220] $61 591%
Cherokee Insurance [1245] $61 591%
Comcar Industries [1280] $61 591%
Equitable [1355] $61 591%
Federated Mutual [1365] $61 591%
Ge Group Administrators [1405] $61 591%
Guardian [1465] $61 591%
Insurers Administrative Corp [1550] $61 591%
Lewer Agency [1565] $61 591%
Medica [2910] $61 591%
Medishare Christian Care [1645] $61 591%
Mega Life And Health [1650] $61 591%
Northamerica Administrators [1725] $61 591%
Pan American Life Insurance Co [1770] $61 591%
Phcs [1780] $61 591%
Phoenix Home Life [1785] $61 591%
Principal Mutual Life [1845] $61 591%
Rh Administrators [1885] $61 591%
Trustmark [2030] $61 - $65 591%
Coresource [1315] $63 610%
Healthpartners [1500] $63 610%
National Association Of Letter Carriers [1695] $63 610%
Allied Benefit Systems Inc [1030] $65 630%
Fmh Benefit Services [1390] $65 630%
Mailhandlers [1595] $65 630%
Rural Carrier Benefit Plan [1895] $65 630%
Allied National Global Care [1035] $74 717%
Combined Insurance Of America [1275] $74 717%
Freedom Life Insurance [1400] $74 717%
Group Health [2165] $74 717%
Kaiser Permanente [1560] $74 717%
Multiplan [1680] $74 717%
Mutual Of Omaha [1685] $74 717%
New Era Life Insurance Company [1705] $74 717%
Pba [1775] $74 717%
Planned Administrators Inc [2360] $74 717%
Universal Fidelity [2085] $74 717%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6819 Plum Creek, Amarillo, TX 79124
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals