CMS Price Transparency Data

Culture, blood

Facility: Saint Joseph Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $139
Cash Discount Price: Unavailable
vs. Medicare Baseline: 13.47x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Saint Joseph Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 13.47x the Medicare baseline. Located in 1375 E 19Th Ave, Denver, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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%)

Insurance Median: $139 (1347%)

Ins. Median: $139 (1347% 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 1347% of the Medicare baseline (a markup of 1247%). 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
Cigna	$7 - $336	68%
Geha	$10 - $195	97%
Select Health	$10	97%
UnitedHealthcare	$10 - $195	97%
Blue Cross Blue Shield	$18 - $274	174%
Denv Hlth Med Plan	$27	262%
Kaiser Perm Hmo	$59 - $142	572%
Kaiser Self Funded	$74 - $142	717%
Kaiser Perm Ppo/Pos	$75 - $146	727%
Allegiance	$80 - $84	775%
Kaiser Mrp	$80 - $84	775%
Kaiser Snp	$80 - $84	775%
Aetna	$119 - $301	1153%
Preferred One	$128 - $134	1240%
Humana	$134 - $141	1298%
Cofinity	$231 - $242	2238%
First Health Network	$231 - $242	2238%
Private Hlthcare Sys	$240 - $252	2326%
Multiplan Inc	$269 - $282	2607%
Midlands Choice	$310 - $326	3004%

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 $X.
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 Saint Joseph 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.