CMS Price Transparency Data

Culture, blood

Facility: Holy Cross Hospital-Davis

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $126
Cash Discount Price: $99
vs. Medicare Baseline: 12.21x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Holy Cross Hospital-Davis is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 12.21x the Medicare baseline. Located in 1600 West Antelope Drive, Layton, UT.

Cash / Self-Pay

$99

Average discount available for prompt cash payment at this facility.

Insurance Median

$126

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: $99 (959%)

Insurance Median: $126 (1221%)

Cash: $99 (959% of Medicare)

Ins. Median: $126 (1221% 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 1221% of the Medicare baseline (a markup of 1121%). 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
Blue Cross Blue Shield	$7 - $148	68%
Cigna	$9 - $198	87%
Medicaid / KanCare	$9	87%
Uuhp	$9 - $24	87%
Humana	$10	97%
Medicare (plans)	$10	97%
Centura Employee Plan	$13	126%
Employer Direct Healthcare	$13	126%
Motivhealth	$13	126%
Select Health	$18 - $121	174%
Molina	$21 - $106	203%
Pehp	$106 - $143	1027%
Aetna	$109 - $209	1056%
Wise	$129 - $131	1250%
Deseret Mutual Benefit Administrators	$152	1473%
Multiplan	$171 - $225	1657%
UnitedHealthcare	$179 - $247	1734%
Emi Health	$215	2083%

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 $99.
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 Holy Cross Hospital-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.