CMS Price Transparency Data

Culture, blood

Facility: Lawrence Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $19
Cash Discount Price: $21
vs. Medicare Baseline: 1.84x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Lawrence Memorial Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.84x the Medicare baseline. Located in 1309 West Main Street, Walnut Ridge, AR.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $21 (203%)

Insurance Median: $19 (184%)

Cash: $21 (203% of Medicare)

Ins. Median: $19 (184% 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.

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	$1 - $20	10%
Ambetter / Centene	$10 - $26	97%
Amerigroup	$10 - $20	97%
Cigna	$10 - $20	97%
Humana	$10 - $20	97%
Allwell	$11 - $21	107%
Wellcare	$11 - $35	107%
Qualchoice	$12 - $26	116%
Arkansas Total Care	$15	145%
Caresource	$15 - $34	145%
Empower Healthcare Solutions	$15	145%
Arkansas Superior Select	$19	184%
Provider Partners Health Plans	$19	184%
Wellcare By Allwell	$19	184%
Wellcare Health Plans	$19	184%
Qualchoice Of Arkansas	$24	233%
Aetna	$28	271%
Assured Benefits Administrators	$30	291%
Healthlink	$33	320%

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 $21.
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 Lawrence Memorial Hospital 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.