CMS Price Transparency Data

Culture, blood

Facility: Memorial Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $88
  • Cash Discount Price: $128
  • vs. Medicare Baseline: 8.53x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Memorial Medical Center is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 8.53x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$128

Average discount available for prompt cash payment at this facility.

Insurance Median
$88

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: $128 (1240%)
Insurance Median: $88 (853%)
Cash: $128 (1240% of Medicare)
Ins. Median: $88 (853% 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 853% of the Medicare baseline (a markup of 753%). 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
Triwest Va Pccc-All Plans $50 484%
Amerigroup Mcr Adv-All Other Plans $51 494%
Blue Cross Blue Shield $51 - $53 494%
Care Improvement Plus - All Other Plans $51 494%
Coventry First Hlth Mcr Adv $51 494%
Multiplan Mcr Adv $51 494%
Superior Allwell Mcr Adv-All Other Plans $51 494%
UnitedHealthcare $51 - $146 494%
Universal American Mcr-All Other Plans $51 494%
Care Improvement Plus Mcr $52 504%
Universal American Snp $54 523%
Ambetter / Centene $61 591%
Amerigroup Chip $88 853%
Amerigroup Star $88 853%
Amerigroup Star Kids $88 853%
Amerigroup Star Plus $88 853%
Comm Health Chip $88 853%
Comm Health Perinatal-All Other Plans $88 853%
Molina Chip/Star-All Plans $88 853%
Scott & White Chip/Star-All Plans $88 853%
Superior Chip/Star $88 853%
Texas Childrens Hp - All Plans $88 853%
Comm Health Mcaid Hmo $92 891%
Comm Health Star $92 891%
Prime Healthcare Services-All Plans $128 1240%
Cigna $137 1328%
Aetna $146 1415%
Capstar Health Network-All Plans $146 1415%
Coventry First Hlth Hmo Ppo-All Other Plans $146 1415%
Healthcare Highways-All Plans $146 1415%
Humana $146 1415%
Corvel Work Comp-All Plans $156 1512%
Galaxy Health Network-All Plans $156 1512%
Independent Med Sys Ppo-All Plans $156 1512%
Multiplan Phcs Ppo-All Other Plans $156 1512%
Provider Select Ppo-All Plans $156 1512%
Three Rivers Ppo-All Plans $156 1512%
Usa Mso - All Plans $156 1512%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals