CMS Price Transparency Data

Culture, blood

Facility: Rochelle Community Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $229
Cash Discount Price: $296
vs. Medicare Baseline: 22.19x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Rochelle Community Hospital is $229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $296. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 22.19x the Medicare baseline. Located in 900 N 2Nd St, Rochelle, IL.

Cash / Self-Pay

$296

Average discount available for prompt cash payment at this facility.

Insurance Median

$229

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: $296 (2868%)

Insurance Median: $229 (2219%)

Cash: $296 (2868% of Medicare)

Ins. Median: $229 (2219% 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 2219% of the Medicare baseline (a markup of 2119%). 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	$15 - $105	145%
Blue Cross Blue Shield	$15 - $300	145%
Medicaid / KanCare	$15	145%
The Alliance-All Plans	$30 - $31	291%
Health Alliance Mcr Adv	$102 - $105	988%
Humana	$102 - $240	988%
UnitedHealthcare	$102 - $270	988%
Va Ccn - All Plans	$102 - $105	988%
Wellcare Mcr Adv - All Plans	$104 - $107	1008%
Cigna	$219 - $225	2122%
Osf Dan Ppo - All Plans	$219 - $225	2122%
Beech Street-All Plans	$234 - $240	2267%
First Health - All Plans	$234 - $240	2267%
Health Alliance-All Other Plans	$234 - $240	2267%
Ecoh-All Plans	$248 - $255	2403%
Hfn-All Plans	$248 - $255	2403%
Quartz Health Solutions-All Plans	$257 - $264	2490%
Multiplan-All Plans	$274 - $282	2655%

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 $296.
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 Rochelle Community 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.