CMS Price Transparency Data

Culture, blood

Facility: Yoakum Community Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $91
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 8.82x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Yoakum Community Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 8.82x the Medicare baseline. Located in 1200 Carl Ramert Drive, Yoakum, TX.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$91

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: $79 (766%)
Insurance Median: $91 (882%)
Cash: $79 (766% of Medicare)
Ins. Median: $91 (882% 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 882% of the Medicare baseline (a markup of 782%). 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
Blue Cross Blue Shield $38 - $91 368%
Humana $50 484%
Kempton Group Admin Ppo-All Plans $50 484%
Medicare (plans) $50 484%
Prime Health Svcs Mcr Advantage $50 484%
Scott & White Mcare Advan $50 484%
Superior Mcr Advantage $50 484%
Triwest Va Ccn-All Plans $50 484%
Tx Independent Hp Mcr Advantage-All Plans $50 484%
UnitedHealthcare $50 - $97 484%
Superior Hix-All Other Plans $62 601%
Entrust - All Plans $84 814%
Medicaid / KanCare $88 - $121 853%
Amera-Net-All Plans $91 882%
Scott & White Ppo-All Other Plans $91 882%
Healthsmart Ppo-All Other Plans $94 911%
Blue Bell Creameries Emp-All Plans $97 940%
Cigna $97 940%
Americas Health Plan-All Plans $103 998%
Beech Street-All Plans $103 998%
Directcare America-All Plans $103 998%
Galaxy Ppo - All Plans $103 998%
Health Star Comm Ip/Op Only - All Plans $103 998%
Medcorp Southwest Ppo-All Plans $103 998%
Medical Control Ppo-All Plans $103 998%
Phcs Multiplan - All Plans $103 998%
Aetna $109 1056%
Healthsmart Work Comp $109 1056%
Prime Health Svcs Ppo-All Other Plans $109 1056%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Carl Ramert Drive, Yoakum, TX 77995
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals