CMS Price Transparency Data

Culture, blood

Facility: Deaconess Illinois Crossroads

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $40
  • Cash Discount Price: $117
  • vs. Medicare Baseline: 3.88x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Deaconess Illinois Crossroads is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 3.88x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.
Cash / Self-Pay
$117

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $117 (1134%)
Insurance Median: $40 (388%)
Cash: $117 (1134% of Medicare)
Ins. Median: $40 (388% 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 388% of the Medicare baseline (a markup of 288%). 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
Blue Cross Blue Shield $4 - $252 39%
UnitedHealthcare $6 - $308 58%
Aetna $10 - $419 97%
Alliance Coal $10 - $11 97%
Care Improvement Plus $10 97%
Deaconess Onecare $10 - $281 97%
Encore Combined $10 - $324 97%
Encore Prime/Elite/Elite + $10 - $291 97%
Humana $10 - $414 97%
Meridian Health Plan $10 97%
Molina Healthcare Of Illinois $10 97%
Mytru Advantage $10 97%
Umwa $10 97%
Wellcare $10 97%
Alter-Net Medical Services, Inc. $17 - $186 165%
Noncontracted $17 165%
Self-Pay $23 - $117 223%
Cigna $26 - $206 252%
Hope Trust $29 - $186 281%
Prime Health Services $50 - $398 484%
Guardian Resources, Inc. $56 - $446 543%
Healthcare'S Finest Network (Hfn) $57 - $451 552%
Medicalcontrol Network Solutions $57 - $451 552%
National Provider Network $57 - $451 552%
Three Rivers Provider Network $58 - $461 562%
Beech Street $59 - $467 572%
Wexford Health Sources $239 - $371 2316%
Great West Healthcare Of Illinois $398 3857%
Multiplan - Primary Network - Phcs $416 4031%
Healthlink $424 - $451 4109%
Coventry Healthcare $447 4331%
First Health $447 4331%
Multiplan - Complementary Network $453 4390%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8 Doctors Park Rd, Mount Vernon, IL 62864
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals