CMS Price Transparency Data

Culture, blood

Facility: Northwestern Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $242
Cash Discount Price: $216
vs. Medicare Baseline: 23.45x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Northwestern Memorial Hospital is $242. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 23.45x the Medicare baseline. Located in 251 E Huron St, Chicago, IL.

Cash / Self-Pay

$216

Average discount available for prompt cash payment at this facility.

Insurance Median

$242

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: $216 (2093%)

Insurance Median: $242 (2345%)

Cash: $216 (2093% of Medicare)

Ins. Median: $242 (2345% 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 2345% of the Medicare baseline (a markup of 2245%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Curaechoice [6100]	$31 - $247	300%
Aetna	$34 - $1,135	329%
Imagine Health [6032]	$36 - $285	349%
Blue Cross Blue Shield	$60 - $1,057	581%
Humana	$60 - $568	581%
Global Medical Management Inc [6090]	$78 - $613	756%
Healthlink [125]	$88 - $1,135	853%
Medpartners [6038]	$94 - $740	911%
Health'S Finest Network [126]	$114 - $965	1105%
Cigna	$134 - $1,135	1298%
First Health Plan [6034]	$134 - $1,057	1298%
Galaxy Health Network [220]	$134 - $1,135	1298%
Multiplan/Phcs [142]	$134 - $1,135	1298%
UnitedHealthcare	$134 - $1,135	1298%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $216.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87040.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Northwestern Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87040.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.