CMS Price Transparency Data

Culture, blood

Facility: Presence Mercy Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $11
  • Cash Discount Price: $10
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Presence Mercy Medical Center is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 1325 N Highland Avenue, Aurora, IL.
Cash / Self-Pay
$10

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $10 (97%)
Insurance Median: $11 (107%)
Cash: $10 (97% of Medicare)
Ins. Median: $11 (107% 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
Cigna $6 - $44 58%
Advocate Helath Partners $10 - $11 97%
Aetna $10 - $11 97%
Blue Cross Blue Shield $10 - $14 97%
Celtic (Wellcare) $10 97%
Clear Spring Health Of Illinois $10 97%
Devoted Health $10 97%
Essential Health Partners $10 - $12 97%
Health Alliance Medical Plan $10 97%
Humana $10 - $11 97%
Longevity Health Plan Of Illinois $10 97%
Medicare (plans) $10 97%
Ravenswood Physicians Associates Ipa $10 97%
Resurrection Physicians Provider Group Ipa $10 - $12 97%
Self-Pay $10 97%
Tricare $10 97%
United Behavioral Health $10 97%
UnitedHealthcare $10 - $13 97%
Harmony Health Plan $11 107%
Medicaid / KanCare $11 107%
Meridian $11 107%
Molina $11 - $15 107%
Provider Partners Health Plan (Pphp) $11 107%
Zing Health Provider Network $11 107%
Access Community Health Network $12 116%
Imagine Health Network, Inc. $15 145%
Clifton Health Systems $16 155%
Ambetter / Centene $17 165%
Hfn Inc (Healthcare Finest Network) $166 1609%
Corvel $169 1638%
Coventry $169 1638%
Workers Comp $169 1638%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1325 N Highland Avenue, Aurora, IL 60506
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals