CMS Price Transparency Data

Culture, blood

Facility: Thomas H Boyd Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $121
Cash Discount Price: $145
vs. Medicare Baseline: 11.72x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Thomas H Boyd Memorial Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $145. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 11.72x the Medicare baseline. Located in 800 School St, Carrollton, IL.

Cash / Self-Pay

$145

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $145 (1405%)

Insurance Median: $121 (1172%)

Cash: $145 (1405% of Medicare)

Ins. Median: $121 (1172% 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 1172% of the Medicare baseline (a markup of 1072%). 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
Aetna	$18 - $121	174%
Blue Cross Blue Shield	$44 - $178	426%
Meridian Hp Mcaid-All Plans	$44	426%
Molina Mcaid-All Plans	$44	426%
UnitedHealthcare	$88 - $123	853%
Health Alliance Mcr Adv	$89 - $121	862%
Wellcare Mcr Adv-All Plans	$89 - $121	862%
Humana	$90 - $122	872%
Health Alliance-All Other Plans	$107 - $145	1037%
Ambetter / Centene	$116 - $157	1124%
Cigna	$125 - $169	1211%
Multiplan-All Plans	$131 - $178	1269%
Healthlink Hmo	$133 - $180	1289%
Healthlink Il Only	$133 - $180	1289%
Healthlink Ppo-All Other Plans	$150 - $204	1453%
Hfn Zelis-All Plans	$159 - $216	1541%

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 $145.
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 Thomas H Boyd 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.