CMS Price Transparency Data

Culture, blood

Facility: Franciscan Health Lafayette

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $228
Cash Discount Price: $104
vs. Medicare Baseline: 22.09x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Franciscan Health Lafayette is $228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 22.09x the Medicare baseline. Located in 1701 S Creasy Ln, Lafayette, IN.

Cash / Self-Pay

$104

Average discount available for prompt cash payment at this facility.

Insurance Median

$228

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: $104 (1008%)

Insurance Median: $228 (2209%)

Cash: $104 (1008% of Medicare)

Ins. Median: $228 (2209% 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 2209% of the Medicare baseline (a markup of 2109%). 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
Blue Cross Blue Shield	$8 - $10	78%
Mdwise [1175]	$10	97%
Medicaid / KanCare	$10 - $12	97%
Medicare (plans)	$10	97%
Unicare [1150]	$10	97%
Managed Health Services [1302]	$12	116%
Workers Comp [1172]	$21	203%
Commercial [2001]	$46 - $472	446%
Managed Care [2000]	$46 - $425	446%
Aetna	$194 - $340	1880%
UnitedHealthcare	$205 - $251	1986%
United Medical Resources [1158]	$228	2209%
United Medical Resources [1301]	$228 - $251	2209%
Humana	$318	3081%
Cigna	$324 - $378	3140%
Great West Insurance [1055]	$324	3140%

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 $104.
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 Franciscan Health Lafayette 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.