CMS Price Transparency Data
Culture, blood
Facility: Clovis Community Medical Center
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $10
- Cash Discount Price: $176
- vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Clovis Community Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 0.97x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$176
Average discount available for prompt cash payment at this facility.
Insurance Median
$10
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: $176 (1705%)
Insurance Median: $10 (97%)
Cash: $176 (1705% of Medicare)
Ins. Median: $10 (97% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Cal Caloptima | $9 | 87% |
| Medi-Cal Contra Costa Health Plan | $9 | 87% |
| Medi-Cal California Health & Wellness Plan | $9 | 87% |
| Medi-Cal Community Health Group | $9 | 87% |
| Fresno County Funded Specialty Care | $9 | 87% |
| Medi-Cal Partnership Health Plan of Ca | $9 | 87% |
| Ccs Mariposa | $9 | 87% |
| Generic Ccs Other Counties | $9 | 87% |
| Santa Clara Family Health Plan - Premier Health | $9 | 87% |
| Medi-Cal Molina | $9 | 87% |
| Medi-Cal Health Plan of San Mateo | $9 | 87% |
| Chdp | $9 | 87% |
| San Francisco Health Plan Medi-Cal | $9 | 87% |
| Ccs Merced | $9 | 87% |
| Generic Care Out of County | $9 | 87% |
| Ccs Kings | $9 | 87% |
| Ccs Madera/Sacramento | $9 | 87% |
| Santa Clara Family Health Plan - Valley Health | $9 | 87% |
| Ccs Stanislaus | $9 | 87% |
| Blue Shield | $9 - $125 | 87% |
| Ccs Fresno | $9 | 87% |
| Medi-Cal Blue Shield Promise Health | $9 | 87% |
| Ccs Tulare | $9 | 87% |
| Gold Coast Medi-Cal | $9 | 87% |
| Medi-Cal Alameda Alliance for Health | $9 | 87% |
| Blue Cross Blue Shield | $9 - $140 | 87% |
| Genetically Handicapped Person | $9 | 87% |
| Medi-Cal La Care Health | $9 | 87% |
| Ccs Kern | $9 | 87% |
| Medi-Cal Kern Family Health | $9 | 87% |
| Medi-Cal Inland Empire Health | $9 | 87% |
| Medi-Cal Cencal Health | $9 | 87% |
| Medicare (plans) | $10 | 97% |
| Todays Pyramid | $10 | 97% |
| Advantek Table Mountain Rancheria Tribal Member | $10 | 97% |
| Sante Sub Cap Healthnet Seniority | $10 | 97% |
| Sante-Healthnet Seniority | $10 | 97% |
| Blue Shield 65 Plus HMO Ehs | $10 | 97% |
| Gemcare HMO | $10 | 97% |
| Us Marshal | $10 | 97% |
| Cares Act Provider Relief Fund | $10 | 97% |
| Sante Sub Cap-Blue Shield/Sante | $10 | 97% |
| Generic Victims of Crime | $10 | 97% |
| Sante-Blue Shield/Sante | $10 | 97% |
| Railroad Part B | $10 | 97% |
| Bscphp HMO - First Choice | $10 | 97% |
| Humana | $10 - $187 | 97% |
| Care1St HMO - Ehs | $10 | 97% |
| Meritage Brand New Day | $10 | 97% |
| Generic | $10 | 97% |
| Meritage Blue Shield 65 Plus | $10 | 97% |
| Scan Health Plan | $10 | 97% |
| Healthnet HMO - La Salle | $10 | 97% |
| Railroad Part A | $10 | 97% |
| Sante-Sub Cap Ma Brand New Day | $10 | 97% |
| Blue Shield 65 Plus HMO First Choice | $10 | 97% |
| Sante | $10 - $14 | 97% |
| Sequoia Pace - Peak Tpa | $10 | 97% |
| Hartford Life Supplement | $10 | 97% |
| Healthnet HMO - Dhmso | $10 | 97% |
| Brand New Day | $10 | 97% |
| Cigna | $10 - $136 | 97% |
| Kaiser | $10 | 97% |
| Healthnet Sante Dual Risk | $10 | 97% |
| Victims of Crime | $10 | 97% |
| Bscphp - First Choice | $10 | 97% |
| UnitedHealthcare | $10 - $115 | 97% |
| Blue Shield Saint Agnes | $10 | 97% |
| Medi-Cal Innovative Integrated Health | $10 | 97% |
| Blue Shield Sante | $10 | 97% |
| Meritage Healthnet HMO | $10 | 97% |
| Wellcare | $10 | 97% |
| Aetna | $10 - $110 | 97% |
| Blue Shield Promise - Imperial | $10 | 97% |
| Blue Shield Hmo-Cvmp/Medpro | $10 | 97% |
| Healthnet HMO - Cvmp/Medpro | $10 | 97% |
| Healthnet Sante | $10 | 97% |
| Railroad Part A & B | $10 | 97% |
| Bscphp - Dhmso | $10 | 97% |
| Healthnet Sante - Sub Cap Dual Risk | $10 | 97% |
| Healthnet HMO - Sante | $10 | 97% |
| Generic Bscphp | $10 | 97% |
| Innovative Integrated Health Community Plans HMO | $11 | 107% |
| Alignment Health Plan | $11 | 107% |
| Champion Health Plan of California Ma | $11 | 107% |
| Imperial Health Plan HMO | $12 | 116% |
| Health Plan of San Joaquin | $13 | 126% |
| Sequoia Pace | $13 | 126% |
| Correctcare Integrated Health | $13 | 126% |
| Adventist -McL Calviva Sub Cap | $15 | 145% |
| Healthnet | $17 - $129 | 165% |
| Coalinga State Hospital | $21 | 203% |
| Naphcare Inc-Mendota | $22 | 213% |
| Central Valley Medical Providers | $55 - $154 | 533% |
| Community Care | $56 | 543% |
| Employer 90/40 | $88 | 853% |
| Nx Health Network PPO | $121 | 1172% |
| Central Ca Indian Health | $121 | 1172% |
| Healthsmart | $150 - $176 | 1453% |
| Coventry Health Care (First Health Network) | $165 | 1599% |
| Network By Design | $165 | 1599% |
| Generic Multiplan | $187 | 1812% |
| PHCS | $187 | 1812% |
| Well Path (Cfmg) | $242 | 2345% |