CMS Price Transparency Data

Culture, blood

Facility: Portneuf Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $366
  • Cash Discount Price: $259
  • vs. Medicare Baseline: 35.47x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Portneuf Medical Center is $366. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $259. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 35.47x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.
Cash / Self-Pay
$259

Average discount available for prompt cash payment at this facility.

Insurance Median
$366

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: $259 (2510%)
Insurance Median: $366 (3547%)
Cash: $259 (2510% of Medicare)
Ins. Median: $366 (3547% 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 3547% of the Medicare baseline (a markup of 3447%). 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 $89 - $366 862%
Healthscope Benefits [2290] $89 862%
UnitedHealthcare $89 - $389 862%
Black Lung [6055] $177 1715%
Employee Benefit Management Services [2445] $177 - $259 1715%
Healthcare Highways [2210] $177 - $410 1715%
Lucent Health [6000] $177 1715%
Moda Health [6100] $177 1715%
Oncology Patient Assistance Programs [2295] $177 1715%
Pending Ssi [1616] $177 1715%
Web Tpa [2115] $177 1715%
Pacific Source Health Plans [2850] $248 2403%
Liberty Health Share Lhs/Medcost Solutions Llc [2400] $259 2510%
Medishare Christian Care [1645] $259 2510%
Multiplan [1680] $289 - $410 2800%
Worker'S Comp [2125] $314 - $324 3043%
Cigna $318 3081%
Enablecomp [1350] $324 3140%
Transamerican Life [1990] $324 3140%
First Health [1375] $356 3450%
Mailhandlers [1595] $366 3547%
Selecthealth [3740] $366 - $389 3547%
Geha [1415] $389 3769%
Humana $389 3769%
Administrative Concepts [1005] $410 3973%
Healthfirst [2395] $410 3973%
Healthnet [1495] $410 3973%
Hometown Health [2155] $410 3973%
Mayo Clinic Health Solutions [2280] $410 3973%
Meritain Health [1655] $410 3973%
Mutual Of Omaha [1685] $410 3973%
National Association Of Letter Carriers [1695] $410 3973%
New Era Life Insurance Company [1705] $410 3973%
Pan American Life Insurance Co [1770] $410 3973%
Pba [1775] $410 3973%
Phcs [1780] $410 3973%
Planned Administrators Inc [2360] $410 3973%
Trustmark [2030] $410 3973%
Ut Id Teamsters [3760] $410 3973%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hospital Way, Pocatello, ID 83201
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals