CMS Price Transparency Data

Culture, blood

Facility: Clinch Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $72
Cash Discount Price: $38
vs. Medicare Baseline: 6.98x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Clinch Memorial Hospital is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 6.98x the Medicare baseline. Located in 1050 Valdosta Highway, Homerville, GA.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $38 (368%)

Insurance Median: $72 (698%)

Cash: $38 (368% of Medicare)

Ins. Median: $72 (698% 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 698% of the Medicare baseline (a markup of 598%). 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
Aetna	$60 - $75	581%
UnitedHealthcare	$63	610%
Caresource	$64 - $75	620%
Cigna	$64	620%
Peach State Health Plan	$64 - $75	620%
Blue Cross Blue Shield	$65	630%
Novanet	$68	659%
Alliant	$72 - $75	698%
Devoted	$72 - $75	698%
Eon Health	$72 - $75	698%
Humana	$72 - $75	698%
Wellcare	$72 - $75	698%
Amerigroup	$75	727%
Clover	$75	727%

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 $38.
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 Clinch Memorial 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.