CMS Price Transparency Data

Culture, blood

Facility: Baylor Scott & White Hospital Brenham

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $107
Cash Discount Price: $151
vs. Medicare Baseline: 10.37x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Baylor Scott & White Hospital Brenham is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.37x the Medicare baseline. Located in 700 Medical Parkway, Brenham, TX.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$107

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: $151 (1463%)

Insurance Median: $107 (1037%)

Cash: $151 (1463% of Medicare)

Ins. Median: $107 (1037% 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 1037% of the Medicare baseline (a markup of 937%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$9	87%
Baylor Scott & White Health Plan	$31 - $107	300%
Triwest	$33	320%
American Health Plan	$34	329%
Blue Cross Blue Shield	$34 - $61	329%
Corvel	$34	329%
Healthspring	$34	329%
Prime Health Services	$34	329%
Procare Advantage	$34	329%
Superior Health Plan	$34	329%
Careworks Fka Rockport	$41	397%
Injury Management Organization	$41	397%
Sedgwick	$41	397%
Cigna	$129 - $151	1250%
Aetna	$138	1337%
Midcoast	$138	1337%
Quiktrip	$138	1337%
University Of Mary Hardin-Baylor	$145	1405%
Independent Medical System	$150	1453%
Imagine Health	$157	1521%
Curative	$163	1579%
First Health	$176	1705%
Healthsmart	$176 - $188	1705%
Humana	$176 - $201	1705%
Private Health Care System	$188	1822%
Bluebell Creameries	$226	2190%

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 $151.
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 Baylor Scott & White Hospital Brenham 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.