CMS Price Transparency Data

Culture, blood

Facility: Montrose Regional Health

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $179
Cash Discount Price: $143
vs. Medicare Baseline: 17.34x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Montrose Regional Health is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $143. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 17.34x the Medicare baseline. Located in 800 S 3Rd St, Montrose, CO.

Cash / Self-Pay

$143

Average discount available for prompt cash payment at this facility.

Insurance Median

$179

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: $143 (1386%)

Insurance Median: $179 (1734%)

Cash: $143 (1386% of Medicare)

Ins. Median: $179 (1734% 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 1734% of the Medicare baseline (a markup of 1634%). 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
United Rocky Mountain Mcaid	$8	78%
Blue Cross Blue Shield	$10 - $179	97%
Humana	$10 - $180	97%
Medicare (plans)	$10	97%
United Rocky Mountain Chp-All Other Plans	$82	795%
Montrose Community Healthplan-All Plans	$162	1570%
Western Healthcare Alliance-All Plans	$171	1657%
United Rocky Mountain Private Plan	$176	1705%
Cigna	$180	1744%
Multiplan-All Plans	$180	1744%
Three Rivers-All Plans	$180	1744%
Uchpa - All Plans	$180	1744%
United Rocky Mountain Self Insured	$180	1744%
UnitedHealthcare	$180	1744%
Sloans Lake Managed Care-All Plans	$181	1754%

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 $143.
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 Montrose Regional Health 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.