CMS Price Transparency Data
Culture, blood
Facility: Children's Hosp of Los Angeles
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $13
- Cash Discount Price: $12
- vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Children's Hosp of Los Angeles is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.26x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
$12
Average discount available for prompt cash payment at this facility.
Insurance Median
$13
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: $12 (116%)
Insurance Median: $13 (126%)
Cash: $12 (116% of Medicare)
Ins. Median: $13 (126% 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.
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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 |
|---|---|---|
| Health Net | $1 - $28 | 10% |
| Intl - Global Excel Management | $2 - $21 | 19% |
| Southern Atlantic Medical Group Mmc | $2 - $29 | 19% |
| Gemcare IPA | $2 - $16 | 19% |
| Good Samaritan Medical Group | $2 - $17 | 19% |
| Adventist Health Physicians | $2 - $22 | 19% |
| Managed Care Systems | $2 - $16 | 19% |
| Molina | $3 - $19 | 29% |
| Medi-Cal | $3 - $12 | 29% |
| Inland Empire Health Plan | $3 - $18 | 29% |
| Shriners Hospital | $7 | 68% |
| Medicaid / KanCare | $7 - $22 | 68% |
| Community Family Care IPA | $9 - $22 | 87% |
| Incentive Health Network | $9 | 87% |
| Beech Street | $9 | 87% |
| Valley Presbyterian Hospital | $9 - $22 | 87% |
| Non-Contract Payors | $9 | 87% |
| Altamed | $9 - $22 | 87% |
| Point Comfort Underwriters | $9 | 87% |
| UnitedHealthcare | $10 - $21 | 97% |
| Emanate Health Medical Center Mmc | $10 | 97% |
| Kaiser | $10 - $13 | 97% |
| Medicare (plans) | $10 | 97% |
| La Care | $10 - $22 | 97% |
| Aetna | $11 - $12 | 107% |
| Accarent Health | $11 | 107% |
| Champus | $11 | 107% |
| St. John's Health Clinic | $11 - $15 | 107% |
| Sansum Clinic | $11 | 107% |
| Book Md | $11 | 107% |
| Choc Health Alliance | $11 | 107% |
| St Francis Medical Center | $11 - $22 | 107% |
| Exceptional Care Medical Group | $11 - $22 | 107% |
| Citrus Valley Phys Grp | $11 - $14 | 107% |
| Staywell Insurance | $11 | 107% |
| Pioneer Prov Ntwk | $11 | 107% |
| Axminster Medical Group | $11 - $15 | 107% |
| Mercy Care | $11 | 107% |
| Facey Medical Group | $11 - $15 | 107% |
| Premier Physicians Ntwk | $12 - $22 | 116% |
| Intl - Quality Health Management | $12 - $22 | 116% |
| National Healthcare Solutions | $12 | 116% |
| Health Care La IPA | $12 - $22 | 116% |
| Community Care | $12 | 116% |
| Global Care Medical Group | $12 - $22 | 116% |
| Choice Medical Group | $12 | 116% |
| Applecare Medical Group | $12 - $22 | 116% |
| Culinary Health Fund | $12 - $21 | 116% |
| Bella Vista Med Grp | $12 - $22 | 116% |
| Centinela Valley IPA | $12 - $22 | 116% |
| Intl - Global Medical Management | $12 | 116% |
| Blue Shield | $12 - $22 | 116% |
| Family Care Specialists | $13 - $22 | 126% |
| Bright Medical Associates | $13 | 126% |
| Emanate Health Medical Center Commercial | $13 | 126% |
| Access Medical Group | $13 | 126% |
| Delta Health Systems | $13 | 126% |
| Seoul Medical Group | $13 | 126% |
| Blue Cross Blue Shield | $13 - $22 | 126% |
| Los Angeles Medical Center IPA | $13 - $22 | 126% |
| El Proyecto Del Barrio | $13 - $22 | 126% |
| Caloptima | $13 - $22 | 126% |
| Ventura County Health Plan | $13 | 126% |
| Self-Pay | $13 | 126% |
| Heritage Provider Network | $13 - $22 | 126% |
| Sanus Health | $13 | 126% |
| Alhambra Hospital Medical Center | $13 - $22 | 126% |
| Private Hlthcare System | $13 | 126% |
| Hollywood Presbyterian Medical Center | $13 - $22 | 126% |
| Preferred IPA - Commercial | $13 | 126% |
| Watts Healthcare Mmc | $13 - $22 | 126% |
| Allied Pacific IPA | $13 - $22 | 126% |
| Axis Services International | $14 | 136% |
| Lakewood Health Plan | $14 | 136% |
| Cedar Sinai Med Grp | $14 | 136% |
| Seaside Health Plan | $14 - $22 | 136% |
| Serra Community Med Clinic - Commercial | $14 | 136% |
| Star Healthcare Network Commercial | $14 | 136% |
| Calvo Selectcare | $14 | 136% |
| Sierra Health and Life Insurance Company | $14 | 136% |
| Intl - Concierge Healthcare Services | $14 | 136% |
| Intl - Erv Travel Services | $14 - $15 | 136% |
| Prime Health Services | $14 | 136% |
| Plotkin Health | $14 | 136% |
| Intl - Aixin Life Insurance Co | $14 - $22 | 136% |
| Intl - Msh China Enterprise Services | $14 | 136% |
| Embassy - Saudi Arabia | $14 | 136% |
| Marian Health Services | $14 | 136% |
| Redlands Community Hospital | $14 | 136% |
| Multiplan | $15 | 145% |
| Beaver Medical Group | $15 | 145% |
| Korean American Med Grp | $15 | 145% |
| Angeles IPA | $15 - $22 | 145% |
| Memorialcare Med Foundation | $15 | 145% |
| Primecare Medical Network | $15 | 145% |
| Serendib Healthways Mmc | $15 - $22 | 145% |
| Avalon IPA | $16 - $22 | 155% |
| Karing Physicians Medical Group | $16 - $22 | 155% |
| Mabuhay Medical Group | $16 - $22 | 155% |
| Interlink Health Services | $16 | 155% |
| White Memorial Medical Center | $16 - $22 | 155% |
| Embassy - Kuwait | $16 | 155% |
| Care 1St | $16 - $22 | 155% |
| Noble Community Medical Associates | $16 - $22 | 155% |
| Providence Health Network | $16 | 155% |
| Cal Care IPA | $16 - $22 | 155% |
| Associated Hispanic Physicians IPA | $16 - $22 | 155% |
| Hispanic Physician IPA | $16 - $22 | 155% |
| Primary Care and Pediatric IPA | $16 - $22 | 155% |
| Regent Medical Group | $16 - $22 | 155% |
| Prospect Medical Group | $16 | 155% |
| Beverly Hospital | $17 - $22 | 165% |
| Accountable Health | $17 - $22 | 165% |
| Cencal Health | $17 - $22 | 165% |
| Gold Coast Health Plan | $17 - $22 | 165% |
| Souther California Hosp System - Mmc | $17 - $22 | 165% |
| Preferred IPA | $17 - $22 | 165% |
| Pacific Alliance Medical Center | $17 - $22 | 165% |
| Family Health Alliance Med Grp | $17 - $22 | 165% |
| San Judas Med Grp | $17 - $22 | 165% |
| Imperial Health Holdings Medical Group | $18 - $22 | 174% |
| Employee Health Systems Med Grp | $18 - $22 | 174% |
| Crown City Medical Group | $18 - $22 | 174% |
| Self-Pay International | $18 | 174% |
| Embassy - All Others | $18 | 174% |
| Healthy New Life Medical Corp | $19 - $22 | 184% |
| Asian Community Medical Group | $19 - $22 | 184% |
| California Pacific Physicians Medical Group | $19 - $22 | 184% |
| Cigna | $20 | 194% |
| Dignity Health | $20 - $22 | 194% |
| Community Care IPA Mmc | $20 - $22 | 194% |
| Serra Community Med Clinic | $22 | 213% |
| Superior Choice Medical Group | $22 | 213% |
| Kern Family Health Plan | $22 | 213% |
| Southland San Gabriel Valley Medical Group | $22 | 213% |