CMS Price Transparency Data

Culture, blood

Facility: Bluffton Regional Medical Center

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 Bluffton Regional Medical Center 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 303 S Main St, Bluffton, 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 $3 - $125 29%
Self Pay $3 - $287 29%
Aetna $4 - $233 39%
Cigna $4 - $185 39%
Lutheran Preferred Network $4 - $418 39%
Blue Cross Blue Shield $5 - $17 48%
Lutheran Trma $5 - $235 48%
Php Management Systems $5 - $202 48%
Encore Ppo $6 - $255 58%
Sagamore Sebt $6 - $267 58%
UnitedHealthcare $6 - $258 58%
Sagamore Health Newtork Inc $7 - $280 68%
Ahg Dana Employees $8 - $339 78%
Consumer Life $8 - $324 78%
Align Networks $9 - $365 87%
Northeast Hospice $9 - $365 87%
Physicians Health Plan $9 - $25 87%
Prime Health Services $9 - $392 87%
Private Healthcare Systems Inc $9 - $392 87%
Advantage 360 $10 - $433 97%
Caresource $10 97%
Department Of Veterans Affairs $10 97%
Encore Health Network $10 - $470 97%
Humana $10 97%
Medicaid / KanCare $10 97%
Medicare (plans) $10 97%
Mhs $10 97%
Mhs In Hip $10 97%
Multiplan $10 - $418 97%
Node Caresource Mcr Adv $10 97%
Node Devoted Health Mcr Adv $10 97%
Node Iu Health Mcr Adv $10 97%
Node Mhs Mcr Adv $10 97%
Node Non Par Hospice Agree $10 97%
Node Va $10 97%
Tricare $10 97%
Veterans Eval Services $10 97%
Allied Benefit Systems $11 - $470 107%
Cardinal Health Alliance $11 - $470 107%
Community Health Alliance $11 - $444 107%
County Jail Health Care $11 107%
First Health $11 - $449 107%
In Dept Of Correction $11 107%
Node Pphp Mcr Adv $11 107%
Ppom $11 - $470 107%
Php $12 - $26 116%
Php Freedom Network $12 - $19 116%
Us Department Of Labor $13 126%
Lutheran Advanced Network $15 145%
Lutheran Three Rivers Preferred Plus 150 $15 145%
Lutheran Three Rivers Preferred Plus 175 $18 174%
Encore Work Comp In $19 184%
Lutheran Northwest Health Preferred $21 203%
Managed Health Services Exchange $21 203%
Workers Compensation $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: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals