Culture, blood
Facility: Kosciusko Community Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $29
- Cash Discount Price: $20
- vs. Medicare Baseline: 2.81x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 281% of the Medicare baseline (a markup of 181%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 - $93 | 29% |
| Self Pay | $3 - $174 | 29% |
| Blue Cross Blue Shield | $5 - $17 | 48% |
| Lutheran Preferred Network | $5 - $356 | 48% |
| Encore | $6 - $178 | 58% |
| Php Freedom Network | $6 - $172 | 58% |
| Physicians Health Plan | $6 - $205 | 58% |
| Trma Inc | $6 - $200 | 58% |
| UnitedHealthcare | $6 - $234 | 58% |
| Aetna | $7 - $237 | 68% |
| Connecticut General Life Insurance Company | $9 - $262 | 87% |
| Caresource | $10 | 97% |
| Cigna | $10 - $281 | 97% |
| Department Of Veterans Affairs | $10 | 97% |
| Humana | $10 | 97% |
| Iu Health | $10 | 97% |
| Managed Health Services | $10 | 97% |
| Medicaid / KanCare | $10 | 97% |
| Medicare (plans) | $10 | 97% |
| Mhs | $10 | 97% |
| Node Devoted Health Mcr Adv | $10 | 97% |
| Node Non Par Hospice Agree | $10 | 97% |
| Node Va | $10 | 97% |
| Tricare | $10 | 97% |
| Veterans Eval Services | $10 | 97% |
| In Dept Of Correction | $11 | 107% |
| Node Pphp Mcr Adv | $11 | 107% |
| First Health Network | $12 - $334 | 116% |
| Prime Health Services | $12 - $334 | 116% |
| Advantage Health | $13 - $369 | 126% |
| Us Department Of Labor | $13 | 126% |
| Private Healthcare Systems | $14 - $383 | 136% |
| Sagamore | $14 - $418 | 136% |
| Encore Health Network | $15 - $414 | 145% |
| Lutheran Advanced Network | $15 | 145% |
| Lutheran Preferred | $15 - $21 | 145% |
| Align In Work Comp | $17 | 165% |
| One Call Work Comp | $17 | 165% |
| Encore Work Comp In | $19 | 184% |
| Managed Health Services Exchange | $21 | 203% |
| Workers Comp | $21 | 203% |
| Encore Kba Epo | $25 | 242% |
| Encore Kba Ppo | $31 | 300% |