CMS Price Transparency Data

Culture, blood

Facility: Methodist Southlake Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $17
  • Cash Discount Price: $260
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Methodist Southlake Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.65x the Medicare baseline. Located in 421 E State Highway 114, Southlake, TX.
Cash / Self-Pay
$260

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $260 (2519%)
Insurance Median: $17 (165%)
Cash: $260 (2519% of Medicare)
Ins. Median: $17 (165% 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.

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
Bind Benefits Inc [1004] $6 58%
Definity Health [3006] $6 58%
Freedom Life Insurance Company [2029] $6 58%
Geha Federal [3066] $6 58%
Tml Intergovernmental Employee Benefits [3050] $6 58%
UnitedHealthcare $6 - $11 58%
Aetna $10 - $291 97%
Blue Cross Blue Shield $10 - $33 97%
Medicare (plans) $10 - $11 97%
Ust Health Proof [1005] $10 97%
Wellcare [7016] $10 97%
American Health Advantage Of Texas [7099] $11 107%
Cigna $11 - $19 107%
Globalhealth [1003] $11 107%
Humana $11 107%
Procare Advantage [7018] $11 107%
Provider Partners Health Plan [7025] $11 107%
Southwestern Health Resources Swhr [7015] $11 107%
Alternative Service Concepts [8005] $13 126%
Oscar Insurance Company [2057] $13 126%
Bright Healthcare [2222] $14 136%
Molina [3017] $15 145%
Wellpoint Marketplace Exchange [3071] $16 155%
90 Degree Benefit [3057] $17 165%
Allied National [2031] $17 165%
Entrust/90 Degree [2058] $17 165%
Kempton Group Administrators, Tower Extrusions [3061] $17 165%
Ambetter / Centene $18 174%
Friday Health Plan [2061] $18 174%
Imperial Insurance Companies [3073] $19 184%
Web Tpa [3049] $19 - $45 184%
Department Of Labor [8004] $21 203%
Evry Health [1013] $21 203%
Generic Workers Comp Tx Non Par [9010] $21 203%
Generic Workers Comp Tx Par [8002] $21 203%
Generic Workers Comp Tx Par [9011] $21 203%
Sana Benefits [3069] $21 203%
Tristar Risk Management [8006] $21 203%
Velocity [3070] $21 203%
Health Plans Inc [5017] $26 252%
Medical Cost Containment Professionals [3059] $26 252%
Dart Member Care [3039] $28 271%
Healthscope Benefits [2052] $28 271%
Healthscope Benefits [3063] $28 271%
Medicaid / KanCare $31 - $37 300%
Scott & White Health Plan Trs [3062] $291 2820%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 421 E State Highway 114, Southlake, TX 76092
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals