Culture, blood
Facility: Saint Mary's Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $21
- Cash Discount Price: $178
- vs. Medicare Baseline: 2.03x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 203% of the Medicare baseline (a markup of 103%). 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.
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 - $24 | 87% |
| Harvard Pilgrim Healthcare | $10 - $21 | 97% |
| Geha | $10 - $21 | 97% |
| Cigna | $10 - $42 | 97% |
| Aetna | $10 - $37 | 97% |
| UnitedHealthcare | $10 - $44 | 97% |
| Cca Senior Care Options | $10 - $21 | 97% |
| Medicare (plans) | $10 - $21 | 97% |
| Connecticare | $11 - $24 | 107% |
| Connecticut Dept of Correction | $11 - $13 | 107% |
| Blue Benefit Administrators of Massachusetts | $12 - $24 | 116% |
| Blue Shield - PA (Highmark) | $12 - $24 | 116% |
| Blue Shield - Id (Regence) | $12 - $24 | 116% |
| Blue Distinction Transplant | $12 - $24 | 116% |
| Pre-Employment | $12 - $24 | 116% |
| Blue Care Network | $12 - $24 | 116% |
| Health Choices | $12 - $24 | 116% |
| Unicare | $12 - $24 | 116% |
| Blue Shield - Ny Highmark Northeastern | $12 - $24 | 116% |
| Blue Shield - Ny Highmark Western | $12 - $24 | 116% |
| Blue Shield - Ca | $12 - $24 | 116% |
| Wc Domestic | $12 - $24 | 116% |
| Bcn Domestic | $12 - $24 | 116% |
| Blue Shield - Wa (Regence) | $12 - $24 | 116% |
| Kaiser Domestic | $12 - $24 | 116% |
| Wellpoint | $12 - $24 | 116% |
| Centivo | $13 - $26 | 126% |
| Luminare Health | $18 - $37 | 174% |
| 1199 National Benefit Fund | $18 - $37 | 174% |
| Webtpa | $18 - $37 | 174% |
| Gravie Admin Services | $18 - $37 | 174% |
| Allied Benefit Systems | $18 - $37 | 174% |
| Nippon Life Ins | $18 - $37 | 174% |
| Meritain | $18 - $37 | 174% |
| Hap | $18 - $37 | 174% |
| Health Partners | $21 - $42 | 203% |
| Allegiance | $21 - $42 | 203% |
| Magnacare | $21 - $42 | 203% |
| Claimdoc | $22 - $43 | 213% |
| Carelon Behavioral Health | $22 | 213% |
| Innovative Health Plan II | $22 - $43 | 213% |
| Diversified Administrators | $22 - $43 | 213% |
| Health New England | $23 | 223% |
| PHCS | $34 | 329% |
| Mvp | $34 | 329% |
| Allied National Global Care | $34 | 329% |
| Ghc Scw | $34 | 329% |
| Paramount HMO | $34 | 329% |
| Asrm - Reliance Standard Life Insurance | $34 | 329% |
| Multiplan | $34 | 329% |
| Pan-American Life | $34 | 329% |
| Fallon Health | $34 | 329% |
| Dean Health | $34 | 329% |
| International Benefit Administrators | $34 | 329% |
| Medi Share | $34 | 329% |
| Trinity Health Share | $34 | 329% |
| Pai | $34 | 329% |
| Family Life Insurance Company | $34 | 329% |
| Manhattan Life | $34 | 329% |
| Lifetime Benefit Solutions | $34 | 329% |
| Christian Care Ministry | $34 | 329% |
| Prime Health Services | $35 | 339% |
| Health Smart | $37 | 359% |
| United Behavioral Health Eap | $44 | 426% |