CMS Price Transparency Data

Culture, blood

Facility: Perry County Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $55
Cash Discount Price: $149
vs. Medicare Baseline: 5.33x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Perry County Memorial Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 5.33x the Medicare baseline. Located in 8885 Sr 237, Tell City, IN.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $149 (1444%)

Insurance Median: $55 (533%)

Cash: $149 (1444% of Medicare)

Ins. Median: $55 (533% 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 533% of the Medicare baseline (a markup of 433%). 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
Bc 130	$5 - $170	48%
Group Insurance	$5 - $213	48%
Nsa	$5 - $131	48%
Medicaid / KanCare	$10 - $213	97%
Medicare (plans)	$10 - $55	97%
Veterans Administration	$10 - $213	97%
Workers Compensation	$106	1027%
Guarantor Liable	$149 - $213	1444%
Pcmh Insurnace	$166 - $213	1609%
Secondary Insurance	$170	1647%
UnitedHealthcare	$170	1647%
Operating Engineers	$181	1754%
Boilermakers Healthcare	$185	1793%
Cigna	$185	1793%
Great West	$185 - $213	1793%
Sagxxxx	$185	1793%
Champus	$213	2064%
Ngs American, Inc	$213	2064%
Patoka Valley	$213	2064%
Southwire	$213	2064%
Tricare	$213	2064%
Wausau Benefits	$213	2064%

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 $149.
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 Perry County Memorial Hospital 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.