CMS Price Transparency Data

Culture, blood

Facility: Ascension Seton Edgar B Davis

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $11
Cash Discount Price: $238
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Ascension Seton Edgar B Davis is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 130 Hays Street, Luling, TX.

Cash / Self-Pay

$238

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

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: $238 (2306%)

Insurance Median: $11 (107%)

Cash: $238 (2306% of Medicare)

Ins. Median: $11 (107% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$7 - $49	68%
Dell Chip/Chip Perinate	$7 - $11	68%
Dell Star	$7 - $12	68%
UnitedHealthcare	$7 - $12	68%
Wellpoint Star	$7 - $11	68%
Wellpoint Star Plus	$7 - $11	68%
Ambetter / Centene	$9 - $12	87%
Wellpoint Chip/Chip Perinate	$9 - $11	87%
Wellpoint Star Kids	$9	87%
Champva	$12 - $14	116%
Humana	$17	165%
Cigna	$24	233%
Seton Performance Plus	$25	242%
Aetna	$27 - $77	262%
Covenant Health	$56	543%
Superior Star	$265	2568%
Superior Star Foster	$265	2568%
Superior Star Kids	$265	2568%
Superior Star Plus	$265	2568%
Superior Chip/Chip Perinate	$298	2888%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $238.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87040.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ascension Seton Edgar B Davis is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87040.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.