CMS Price Transparency Data

Culture, blood

Facility: Valley Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $30
  • Cash Discount Price: $197
  • vs. Medicare Baseline: 2.91x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Valley Medical Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 2.91x the Medicare baseline. Located in 400 S 43Rd St, Renton, WA.
Cash / Self-Pay
$197

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $197 (1909%)
Insurance Median: $30 (291%)
Cash: $197 (1909% of Medicare)
Ins. Median: $30 (291% 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 291% of the Medicare baseline (a markup of 191%). 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
Aetna $10 97%
Blue Cross Blue Shield $10 - $19 97%
Chpw Med Advantage [210102] $10 97%
Humana $10 - $11 97%
Medicare (plans) $10 - $11 97%
Premera Medadvantage [210114] $10 97%
Regence Blue Shield [170100] $10 97%
Regence Hma [170105] $10 97%
Regence Hma1 [170102] $10 97%
Regence Medadvantage [210111] $10 97%
Regence Uniform [130111] $10 97%
UnitedHealthcare $10 - $30 97%
Wellpoint Medadvantage [210115] $10 97%
Bh United [180100] $12 116%
Chpw [130116] $17 165%
Molina [130117] $18 174%
Empire Plan [130124] $19 184%
Cigna $21 203%
Providence Health [130125] $21 203%
Benefit Md [150113] $30 291%
Carpenters Trust [150122] $30 291%
Cement Masons And Plasterers [150127] $30 291%
Coresource [150109] $30 291%
Employee Benefit Management Services [150108] $30 291%
Fc Moda Health [150139] $30 291%
First Choice Health Administrators [150110] $30 291%
First Choice Health Comp [150112] $30 291%
First Choice [150134] $30 291%
Health Net [150111] $30 291%
Here [150114] $30 291%
Hotel Employees Health Trust [150115] $30 291%
International Longshore & Warehouse Union [150116] $30 291%
Kitsap Physician Services [150118] $30 291%
Loomis Benefits West [150119] $30 291%
Mega [150120] $30 291%
Midwest [150121] $30 291%
Nw Administrators [150123] $30 291%
Operating Engineers [150125] $30 291%
Painters Trust [150126] $30 291%
Puget Sound Electric [150131] $30 291%
Seattle Plumb And Pipe [150132] $30 291%
Trusteed Plan [150101] $30 291%
United Employee Benefit Trust [150137] $30 291%
Washington Bakers Trust [150102] $30 291%
Washington Employers Trust [150103] $30 291%
Washington State Health Ins Pool [150104] $30 291%
Welfare Pension Administration Services [150105] $30 291%
Zenith Admin [150106] $30 291%
Zzjohn Alden [150117] $30 291%
Zzprincipal Financial Group [150128] $30 291%
Zzprovidence [150129] $30 291%
Kaiser Washington Contracted [130118] $38 368%
Kaiser Washington Non Contracted [140116] $38 368%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 S 43Rd St, Renton, WA 98055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals