CMS Price Transparency Data

Culture, blood

Facility: Northwest Health - Starke

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $10
  • Cash Discount Price: $57
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Northwest Health - Starke is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 0.97x the Medicare baseline. Located in 102 E Culver Rd, Knox, IN.
Cash / Self-Pay
$57

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $57 (552%)
Insurance Median: $10 (97%)
Cash: $57 (552% of Medicare)
Ins. Median: $10 (97% 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
Lutheran $2 - $110 19%
Medpartners $2 - $137 19%
Physicians Health Plan $2 - $169 19%
Self Pay $2 - $225 19%
Alpha Baking $3 - $184 29%
Php $3 - $246 29%
Encore $4 - $356 39%
UnitedHealthcare $4 - $290 39%
Aetna $5 - $354 48%
Blue Cross Blue Shield $5 - $17 48%
Cigna $5 - $340 48%
Community Health Alliance $5 - $368 48%
Coventry First Health $5 - $354 48%
Lutheran Network $5 - $360 48%
Multiplan Inc $5 - $368 48%
Ppom $5 - $385 48%
Sagamore Health Network $5 - $360 48%
Tricare $5 - $10 48%
Humana $6 - $10 58%
In Dept Of Correction $6 - $11 58%
Managed Health Services $6 - $21 58%
Medicare (plans) $6 - $10 58%
Node Champva $6 - $10 58%
Node Devoted Health Mcr Adv $6 - $10 58%
Node Hospice Non Par Agree $6 - $10 58%
Node Pphp Mcr Adv $6 - $11 58%
Node Va $6 - $10 58%
Us Department Of Labor $7 - $13 68%
Caresource $10 97%
Medicaid / KanCare $10 97%
Mhs $10 97%
Indiana Workers Comp $11 - $21 107%
Encore Kba Epo $14 - $25 136%
Magnacare Ma $14 - $25 136%
Encore Kba Ppo $17 - $31 165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 E Culver Rd, Knox, IN 46534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals