CMS Price Transparency Data

Culture, blood

Facility: Mt Sinai Hospital Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $19
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 1.84x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Mt Sinai Hospital Medical Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.84x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $50 (484%)
Insurance Median: $19 (184%)
Cash: $50 (484% of Medicare)
Ins. Median: $19 (184% 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.

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
Oscar - All Plans $2 - $78 19%
Lawndale Christian - All Plans $3 - $57 29%
Partners In Hlth - All Plans $6 - $114 58%
Blue Cross Blue Shield $7 - $181 68%
Healthlink Hmo $8 - $142 78%
Healthlink Ppo - All Other Plans $8 - $142 78%
Advocate Physician Prtnrs Mcr $10 97%
Cenpatico Illinicare Dual $10 97%
Cenpatico Illinicare Mcr - All Other Plans $10 97%
Cigna $10 - $351 97%
Compsych Ip/Op Only - All Plans $10 - $170 97%
Humana $10 - $892 97%
Meridian/Harmony D-Snp - All Plans $10 97%
Nextlevel Hlth Icp Fhp Aca - All Plans $10 97%
Tricare $10 97%
UnitedHealthcare $10 97%
Va Healthnet - All Plans $10 97%
Advocate Physician Prtnrs - All Other Plans $11 107%
Aetna $11 - $642 107%
Ambetter / Centene $11 - $298 107%
Family Health Network Mcaid - All Plans $11 107%
Harmony Behavioral Htlh - All Plans $11 107%
Hfn Platinum $11 - $185 107%
Molina Mcaid $11 107%
Molina Mcr - All Other Plans $11 107%
Multiplan Primary Ntwrk/Phcs - All Other Plans $11 - $199 107%
Zing Mcr Adv - All Plans $11 107%
Hfn Epo $13 - $227 126%
Multiplan Complementary Ntwrk $13 - $227 126%
Hfn Ppo - All Other Plans $14 - $250 136%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals