CMS Price Transparency Data

Culture, blood

Facility: Sarah Bush Lincoln Health Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $128
  • Cash Discount Price: $159
  • vs. Medicare Baseline: 12.40x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Sarah Bush Lincoln Health Center is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 12.40x the Medicare baseline. Located in 1000 Health Center Drive P O Box 372, Mattoon, IL.
Cash / Self-Pay
$159

Average discount available for prompt cash payment at this facility.

Insurance Median
$128

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: $159 (1541%)
Insurance Median: $128 (1240%)
Cash: $159 (1541% of Medicare)
Ins. Median: $128 (1240% 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 1240% of the Medicare baseline (a markup of 1140%). 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 - $145 97%
Bc Comm Mmai $10 97%
Beacon Health Options Behav-All Plans $10 97%
Hlth Alliance Mcr Adv $10 97%
Humana $10 - $11 97%
Meridian Mmai-All Other Plans $10 97%
Molina Mmai-All Other Plans $10 97%
Tricare $10 97%
UnitedHealthcare $10 - $134 97%
Va Ccn-All Plans $10 97%
Wellcare Med Adv-All Plans $10 97%
Bc Comm Care Mcaid $11 107%
Bc Med Adv Ppo/Hmo $11 107%
Hlth Alliance Mcaid $11 107%
Meridian Mcaid $11 107%
Molina Mcaid $11 107%
Plain Church Mg-All Plans $62 - $64 601%
Mennonite-All Plans $70 - $72 678%
Eiu Athlete-All Other Plans $109 - $113 1056%
Healthscope-All Plans $115 - $119 1114%
Rural King-All Plans $115 - $119 1114%
Blue Cross Blue Shield $123 - $129 1192%
Consociate-All Plans $125 - $129 1211%
Hope Trust-All Plans $125 - $129 1211%
Eiu Student $128 - $132 1240%
Allied National-All Plans $131 - $135 1269%
Companion Life-All Plans $131 - $135 1269%
Hlth Alliance-All Other Plans $131 - $135 1269%
First Health-All Plans $133 - $137 1289%
Innovative Hlthware-All Plans $133 - $137 1289%
Healthlink Hmo $134 - $138 1298%
Healthlink Ppo - All Other Plans $134 - $138 1298%
Multiplan-All Plans $134 - $138 1298%
Cigna $140 - $145 1357%
Cphp-All Plans $140 - $145 1357%
Beech Street-All Plans $144 - $148 1395%
Hfn-All Plans $144 - $148 1395%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Health Center Drive P O Box 372, Mattoon, IL 61938
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals