CMS Price Transparency Data

Culture, blood

Facility: Mount Sinai Rehabilitation Hospital Inc

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $39
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 3.78x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Mount Sinai Rehabilitation Hospital Inc is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 3.78x the Medicare baseline. Located in 490 Blue Hills Ave, Hartford, CT.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $39 (378%)
Insurance Median: $39 (378%)
Cash: $39 (378% of Medicare)
Ins. Median: $39 (378% 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 378% of the Medicare baseline (a markup of 278%). 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
Aetna $10 - $14 97%
Blue Cross Blue Shield $10 - $39 97%
Cca Senior Care Options $10 97%
Cigna $10 - $14 97%
Geha $10 97%
Harvard Pilgrim Healthcare $10 97%
Medicare (plans) $10 - $11 97%
UnitedHealthcare $10 97%
1199 National Benefit Fund $14 136%
Allegiance $14 136%
Allied Benefit Systems $14 136%
Gravie Admin Services $14 136%
Hap $14 136%
Health Partners $14 136%
Luminare Health $14 136%
Magnacare $14 136%
Meritain $14 136%
Nippon Life Ins $14 136%
Webtpa $14 136%
Claimdoc $22 213%
Diversified Administrators $22 213%
Innovative Health Plan Ii $22 213%
Connecticut Dept Of Correction $31 300%
Health New England $38 368%
Bcn Domestic $39 378%
Blue Benefit Administrators Of Massachusetts $39 378%
Blue Care Network $39 378%
Blue Distinction Transplant $39 378%
Blue Shield - Ca $39 378%
Blue Shield - Id (Regence) $39 378%
Blue Shield - Ny Highmark Northeastern $39 378%
Blue Shield - Ny Highmark Western $39 378%
Blue Shield - Pa (Highmark) $39 378%
Blue Shield - Wa (Regence) $39 378%
Health Choices $39 378%
Kaiser Domestic $39 378%
Pre-Employment $39 378%
Unicare $39 378%
Wc Domestic $39 378%
Allied National Global Care $48 465%
Asrm - Reliance Standard Life Insurance $48 465%
Christian Care Ministry $48 465%
Dean Health $48 465%
Family Life Insurance Company $48 465%
Ghc Scw $48 465%
International Benefit Administrators $48 465%
Lifetime Benefit Solutions $48 465%
Manhattan Life $48 465%
Medi Share $48 465%
Multiplan $48 465%
Mvp $48 465%
Pai $48 465%
Pan-American Life $48 465%
Paramount Hmo $48 465%
Phcs $48 465%
Trinity Health Share $48 465%
Prime Health Services $57 552%
Connecticare $58 - $64 562%
Health Smart $60 581%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 490 Blue Hills Ave, Hartford, CT 06112
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL