CMS Price Transparency Data

Culture, blood

Facility: Memorial Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $279
  • Cash Discount Price: $465
  • vs. Medicare Baseline: 27.03x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Memorial Medical Center is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $465. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 27.03x the Medicare baseline. Located in 701 N First St, Springfield, IL.
Cash / Self-Pay
$465

Average discount available for prompt cash payment at this facility.

Insurance Median
$279

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: $465 (4506%)
Insurance Median: $279 (2703%)
Cash: $465 (4506% of Medicare)
Ins. Median: $279 (2703% 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 2703% of the Medicare baseline (a markup of 2603%). 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
Health Alliance $5 - $302 48%
Veterans Administration $7 68%
Blue Cross Blue Shield $9 - $465 87%
Aetna $10 - $353 97%
Medicare (plans) $10 - $465 97%
Tricare $10 97%
UnitedHealthcare $10 - $288 97%
Humana $11 - $279 107%
Medicaid / KanCare $11 107%
Molina $11 107%
Healthlink $36 - $293 349%
Commercial Workers Compensation $147 1424%
Illinois Workers Compensation $155 1502%
Current Health Network Ppo $209 2025%
Cigna $244 2364%
Phcs/Multiplan $251 - $279 2432%
6 Degrees Health $279 2703%
Hopetrust $279 2703%
Hst $279 2703%
Magellan $279 2703%
Consociate $302 2926%
Hfn $302 2926%
Preferred Plan $349 3382%
Soi Mcfarland $349 3382%
Soi Rushville $349 3382%
Corvel $372 3605%
Methodist First Choice $372 3605%
Mutual Medical Plans $395 3828%
Liability $465 4506%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N First St, Springfield, IL 62702
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals