CMS Price Transparency Data

Culture, blood

Facility: Lovelace Regional Hospital - Roswell

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $213
Cash Discount Price: $71
vs. Medicare Baseline: 20.64x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Lovelace Regional Hospital - Roswell is $213. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 20.64x the Medicare baseline. Located in 117 East 19Th Street, Roswell, NM.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$213

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: $71 (688%)

Insurance Median: $213 (2064%)

Cash: $71 (688% of Medicare)

Ins. Median: $213 (2064% 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 2064% of the Medicare baseline (a markup of 1964%). 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
Presbyterian Health Plan [1830]	$47	455%
Magellan Behavioral Commercial [2895]	$47	455%
The Health Plan [2915]	$48	465%
UnitedHealthcare	$76	736%
Medicare (plans)	$118	1143%
Zelis [2385]	$118	1143%
Benefit Management [1175]	$118	1143%
Caprock Health Plans [1200]	$154	1492%
Cigna	$163	1579%
Samba Health [2305]	$163	1579%
Pan American Life Insurance Co [1770]	$213	2064%
Administrative Concepts [1005]	$213	2064%
Multiplan [1680]	$213	2064%
Allied National Global Care [1035]	$213	2064%
Boon-Chapman [2375]	$213	2064%
Northamerica Administrators [1725]	$213	2064%
Trustmark [2030]	$213	2064%
Aetna	$213	2064%
Employee Benefit Management Services [2445]	$213	2064%
Coresource [1315]	$213	2064%
Healthcost Solutions [2415]	$213	2064%
Kaiser Permanente [1560]	$213	2064%
PHCS [1780]	$213	2064%
American Medical Security [2190]	$213	2064%
Allied Benefit Systems Inc [1030]	$213	2064%
Emblem Health [2430]	$213	2064%
National Telephone Cooperative [1700]	$213	2064%
Mutual of Omaha [1685]	$213	2064%

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 $71.
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 Lovelace Regional Hospital - Roswell 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.