Culture, blood
Facility: Harrison County Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $87
- Cash Discount Price: $164
- vs. Medicare Baseline: 8.43x 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 843% of the Medicare baseline (a markup of 743%). 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 |
|---|---|---|
| UnitedHealthcare | $5 - $87 | 48% |
| Blue Cross Blue Shield | $9 - $87 | 87% |
| Aetna | $10 - $87 | 97% |
| Caresource Mcaid Hhw | $10 | 97% |
| Mdwise Mcaid Hhw/Hcc - All Other Plans | $10 | 97% |
| Mhs Mcaid Hhw/Hcc | $10 | 97% |
| Siho Ppo/Hmo - All Other Plans | $14 - $43 | 136% |
| Tricare | $26 - $80 | 252% |
| Caresource Mcaid Hip | $28 - $87 | 271% |
| Caresource Mcr Adv | $28 - $87 | 271% |
| Humana | $28 - $276 | 271% |
| Mdwise Mcaid Hip | $28 - $87 | 271% |
| Mhs Exchange-All Other Plans | $28 - $87 | 271% |
| Mhs Mcaid Hip | $28 - $87 | 271% |
| Passport Mcaid-All Other Plans | $28 - $87 | 271% |
| Passport Mcr Adv | $28 - $87 | 271% |
| Communicare Adv-All Plans | $29 - $88 | 281% |
| Mhs Mcr Adv | $29 - $88 | 281% |
| Siho Exchange | $29 - $89 | 281% |
| Passport Mcaid Beh Hlth | $34 - $103 | 329% |
| Caresource Exchange-All Other Plans | $37 - $113 | 359% |
| Buckeye Exchange-All Plans | $47 - $143 | 455% |
| Siho One Southern | $68 - $206 | 659% |
| Encore Encircle | $108 - $330 | 1047% |
| Sagamore-All Plans | $108 - $330 | 1047% |
| Beech Street Comm-All Plans | $115 - $351 | 1114% |
| First Health-All Plans | $115 - $351 | 1114% |
| Cigna | $122 - $372 | 1182% |
| Encore Ppo - All Other Plans | $122 - $372 | 1182% |
| Multiplan-All Plans | $122 - $372 | 1182% |