CMS Price Transparency Data

Culture, blood

Facility: Sartori Memorial Hospital, Inc

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $28
  • Cash Discount Price: $315
  • vs. Medicare Baseline: 2.71x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Sartori Memorial Hospital, Inc is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $315. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 2.71x the Medicare baseline. Located in 515 College Street, Cedar Falls, IA.
Cash / Self-Pay
$315

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $315 (3052%)
Insurance Median: $28 (271%)
Cash: $315 (3052% of Medicare)
Ins. Median: $28 (271% 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 271% of the Medicare baseline (a markup of 171%). 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 - $56 97%
Blue Cross Blue Shield $10 - $20 97%
Geha $10 - $21 97%
Iowa Total Care $10 - $20 97%
Medicaid / KanCare $10 - $20 97%
Medicare (plans) $10 - $21 97%
UnitedHealthcare $10 - $93 97%
Amish Hospital Aid $14 - $27 136%
Oscar $16 - $32 155%
Ambetter / Centene $17 - $35 165%
Centivo $17 - $34 165%
Claimdoc $21 - $41 203%
Nova $21 - $41 203%
Health Choices $22 213%
Medical Associates $22 213%
Allied Benefit Systems $28 - $56 271%
Asr Health Benefits $28 - $56 271%
Coventry $28 - $56 271%
First Health $28 - $56 271%
Lucent Health $28 - $56 271%
Luminare Health $28 - $56 271%
Medical Mutual $28 - $56 271%
Meritain $28 - $56 271%
Webtpa $28 - $56 271%
Health Partners $30 291%
Auxiant $66 640%
Cigna $66 640%
Medica $66 640%
Midlands $66 640%
Midlands Choice $66 640%
Iowa Dept Of Public Health $93 901%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 515 College Street, Cedar Falls, IA 50613
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals