CMS Price Transparency Data
Culture, blood
Facility: Mercy Hospital Berryville
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $64
- Cash Discount Price: $155
- vs. Medicare Baseline: 6.20x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Mercy Hospital Berryville is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 6.20x the Medicare baseline. Located in 214 Carter Street, Berryville, AR.
Cash / Self-Pay
$155
Average discount available for prompt cash payment at this facility.
Insurance Median
$64
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: $155 (1502%)
Insurance Median: $64 (620%)
Cash: $155 (1502% of Medicare)
Ins. Median: $64 (620% 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 620% of the Medicare baseline (a markup of 520%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $9 - $61 | 87% |
| Medicaid / KanCare | $9 - $92 | 87% |
| United Medical Resources Contracted [320454] | $9 - $202 | 87% |
| UnitedHealthcare | $9 - $61 | 87% |
| Summit Community Care Contracted [320368] | $15 | 145% |
| Summit Community Care [20368] | $15 | 145% |
| Arkansas Total Care Contracted [320039] | $33 | 320% |
| Qual Choice Contracted [320324] | $45 | 436% |
| Aetna | $61 | 591% |
| American Health Advantage Of Mo Mcr [20264] | $61 | 591% |
| Cherokee Nation Health Serv Contracted [320066] | $61 | 591% |
| Cross Timbers Hospice [20098] | $61 | 591% |
| Dept Of Veteran Affairs Contracted [320106] | $61 | 591% |
| Elara Caring Aspire Hospice [20433] | $61 | 591% |
| Globalhealth Contracted [320145] | $61 | 591% |
| Halo Hcr Inc Hospice Contracted [320432] | $61 | 591% |
| Halo Hcr Inc Hospice [20432] | $61 | 591% |
| Humana | $61 - $202 | 591% |
| Independent Health [20197] | $61 | 591% |
| Indian Health Service Contracted [320198] | $61 | 591% |
| Indian Health Service [20198] | $61 | 591% |
| Jordan Valley Senior Care Pace [20515] | $61 | 591% |
| Kindful Hospice Contracted [320434] | $61 | 591% |
| Kindful Hospice [20434] | $61 | 591% |
| Medical Associates Health [20444] | $61 | 591% |
| Medicare (plans) | $61 - $64 | 591% |
| Mercy Hospice Okc [20252] | $61 | 591% |
| Mercy Mgd Behavioral Health Contracted [320259] | $61 | 591% |
| Pace Of The Ozarks [20518] | $61 | 591% |
| Provider Partners Health Plans Contracted [320450] | $61 | 591% |
| Qual Choice Contracted [320325] | $61 | 591% |
| Spina Bifida Hlthcare Benefit [20506] | $61 | 591% |
| Valir Pace [20503] | $61 | 591% |
| Wellfirst Health Mcr [20443] | $61 | 591% |
| Tricare | $62 | 601% |
| Cigna | $64 | 620% |
| Mercy Interfacility [20513] | $69 | 669% |
| Healthscope Contracted [320182] | $76 | 736% |
| Ambetter / Centene | $92 | 891% |
| Home State Health Plan Contracted [320187] | $92 | 891% |
| Novasys Contracted [320285] | $96 | 930% |
| Administrative Payor Contracted [320005] | $107 | 1037% |
| Auxiant Contracted [320462] | $143 - $214 | 1386% |
| Healthlink Contracted [320179] | $155 - $202 | 1502% |
| Mercy Benefit Admin Contracted [320251] | $155 - $202 | 1502% |
| Personify Health Contracted [320051] | $155 | 1502% |
| Preferred Health Plan Contracted [320522] | $155 | 1502% |
| Insurance System Inc Contracted [320465] | $190 | 1841% |
| Point C Contracted [320238] | $190 | 1841% |
| Medica Contracted [320239] | $201 | 1948% |
| 90 Degree Benefits Contracted [320436] | $202 | 1957% |
| Aither Health Contracted [320449] | $202 | 1957% |
| Benefit Management Contracted [320052] | $202 | 1957% |
| Ebms Contracted [320493] | $202 | 1957% |
| Edison Health Solutions Contracted [320502] | $202 | 1957% |
| First Health Contracted [320128] | $202 | 1957% |
| Healthsmart Preferred Care Contracted [320184] | $202 | 1957% |
| Imagine 360 Contracted [320494] | $202 | 1957% |
| Ppo Plus Contracted [320310] | $202 | 1957% |
| Reflect Health Contracted [320492] | $202 | 1957% |
| Show-Me Health Administrators Contracted [320483] | $202 | 1957% |
| Multiplan Contracted [320270] | $226 | 2190% |
| Private Health Care Systems Contracted [320320] | $226 | 2190% |