CMS Price Transparency Data

Culture, blood

Facility: Anderson Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $16
  • Cash Discount Price: $160
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Anderson Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.55x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.
Cash / Self-Pay
$160

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $160 (1550%)
Insurance Median: $16 (155%)
Cash: $160 (1550% of Medicare)
Ins. Median: $16 (155% 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
Aetna $10 - $16 97%
Clear Springs Health $10 97%
Devoted Health Ppo $10 97%
Essence $10 - $11 97%
Humana $10 97%
Medicare (plans) $10 97%
Tricare $10 97%
UnitedHealthcare $10 - $17 97%
Medicaid / KanCare $11 - $14 107%
Health Care Service Corporation $12 - $147 116%
Ambetter / Centene $15 145%
Blue Choice $15 145%
Mercy Benefit Admin $17 165%
Mercy Aco $18 174%
Hopetrust $26 252%
Work Comp $46 - $26,600 446%
Healthlink $57 552%
Self Pay $160 - $25,000 1550%
Blue Cross Blue Shield $172 - $178 1667%
Cigna $241 2335%
Multiplan/Phcs $241 2335%
Beech Street Corporation $289 2800%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 State Route 162, Maryville, IL 62062
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals