CMS Price Transparency Data

Culture, blood

Facility: St Luke's Sugar Land Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $22
  • Cash Discount Price: $246
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a Culture, blood at St Luke's Sugar Land Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $246. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 2.13x the Medicare baseline. Located in 1317 Lake Pointe Parkway, Sugar Land, TX.
Cash / Self-Pay
$246

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $246 (2384%)
Insurance Median: $22 (213%)
Cash: $246 (2384% of Medicare)
Ins. Median: $22 (213% 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 213% of the Medicare baseline (a markup of 113%). 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
Renaissance $7 68%
Blue Cross Blue Shield $9 - $53 87%
Tchp $9 - $12 87%
United $9 - $330 87%
UnitedHealthcare $9 - $580 87%
Wellpoint $9 - $15 87%
Chc $10 - $386 97%
Cigna $10 - $491 97%
Humana $10 - $456 97%
Selectcare $10 97%
Aetna $11 - $477 107%
Amerivantage $11 107%
Devoted $11 107%
Kindred $11 107%
Scanhealth $11 107%
Kelsey $13 126%
Kelseycare $14 136%
Community Health Choice $15 145%
Superior Health Plan $15 145%
Bright Health $17 165%
Nx Health $34 329%
Tchpchip $246 - $302 2384%
Texastruechoice $386 3740%
Coventry $456 4419%
First Health $456 4419%
Healthsmart $491 4758%
Interlink $491 4758%
Multiplan $526 5097%
USA Health Network $597 5785%
Mhealth Network $702 6802%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1317 Lake Pointe Parkway, Sugar Land, TX 77478
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals