CMS Price Transparency Data

Culture, blood

Facility: St Joseph Health System, LLC

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $17
  • Cash Discount Price: $12
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Culture, blood at St Joseph Health System, LLC is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.65x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$12

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $12 (116%)
Insurance Median: $17 (165%)
Cash: $12 (116% of Medicare)
Ins. Median: $17 (165% 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
Amish Aid $2 - $114 19%
Self Pay $2 - $262 19%
Cigna $3 - $476 29%
Lutheran Preferred $3 - $286 29%
Blue Cross Blue Shield $4 - $173 39%
Php $4 - $190 39%
Aetna $5 - $324 48%
Encore Ppo $5 - $428 48%
Lutheran Network $5 - $262 48%
Sagamore $5 - $258 48%
Three Rivers $5 - $214 48%
UnitedHealthcare $5 - $237 48%
Multiplan $7 - $371 68%
Align Network $8 - $381 78%
First Health $8 - $357 78%
Frontpath Health Coalition $8 - $381 78%
Prime Health Services $8 - $357 78%
Tricare $8 - $10 78%
Advantage Health Solutions $9 - $395 87%
Allied Benefit Systems $9 - $428 87%
Caresource $10 97%
Department Of Veterans Affairs $10 97%
Humana $10 97%
Managed Health Services $10 - $21 97%
Medicaid / KanCare $10 97%
Medical Mutual Of Ohio $10 - $476 97%
Medicare (plans) $10 97%
Node Devoted Health Mcr Adv $10 97%
Node Hospice Non Par Agree $10 97%
Node Va $10 97%
Parkview Healthplan Services $10 - $476 97%
Php Freedom Network $10 - $19 97%
Value Options $10 - $476 97%
Veterans Eval Services $10 97%
In Dept Of Correction $11 107%
Node Pphp Mcr Adv $11 107%
Us Department Of Labor $13 126%
Lutheran Advanced Network $15 145%
Encore Work Comp In $19 184%
Work Comp $21 203%
Encore Kba Epo $25 242%
Encore Kba Ppo $31 300%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals