CMS Price Transparency Data

Culture, blood

Facility: Hammond Henry Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $184
Cash Discount Price: $224
vs. Medicare Baseline: 17.83x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Hammond Henry Hospital is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 17.83x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$224

Average discount available for prompt cash payment at this facility.

Insurance Median

$184

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: $224 (2171%)

Insurance Median: $184 (1783%)

Cash: $224 (2171% of Medicare)

Ins. Median: $184 (1783% 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 1783% of the Medicare baseline (a markup of 1683%). 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	$20 - $187	194%
Blue Cross Blue Shield	$20 - $149	194%
Meridian Health Plan-All Plans	$20	194%
Quad City Community Hc-All Plans	$26	252%
Geneseo Good Samaritan Village Op Only-All Plans	$54	523%
Tricare	$65	630%
Health Alliance Mcare Adv	$72	698%
UnitedHealthcare	$72 - $184	698%
Humana	$73 - $224	707%
Wellmark Of Ia-All Plans	$124	1202%
Springfield Armory-All Plans	$162	1570%
Ambetter / Centene	$174	1686%
Health Alliance-All Other Plans	$187	1812%
Multiplan Integrated Hp	$187	1812%
Cigna	$192	1860%
Multiplan Pponext	$199	1928%
Osf Direct Access Network-All Plans	$199	1928%
Multiplan-All Other Plans	$212	2054%
Corvel-All Plans	$224	2171%
Healthsmart Adult-All Other Plans	$224	2171%
Healthsmart Pediatric	$224	2171%
Hfn-All Plans	$224	2171%
Multiplan Beech Street	$224	2171%
Multiplan Phcs Adult	$224	2171%
Multiplan Phcs Pediatric	$224	2171%
Usa Mco-All Plans	$224	2171%

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 $224.
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 Hammond Henry 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.