Culture, blood
Facility: Saint John Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $11
- Cash Discount Price: $10
- vs. Medicare Baseline: 1.07x 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.
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 | $9 - $14 | 87% |
| Medicaid / KanCare | $9 | 87% |
| Cigna | $10 | 97% |
| Healthy Blue | $10 - $11 | 97% |
| Celtic | $10 - $66 | 97% |
| Midland Care Connection | $10 | 97% |
| Tricare | $10 | 97% |
| Aetna | $10 - $18 | 97% |
| Medicare (plans) | $10 | 97% |
| Kansas Superior Select | $11 | 107% |
| Employer Direct Healthcare | $14 | 136% |
| Corizon | $14 | 136% |
| Well Path | $14 | 136% |
| Centurion | $15 | 145% |
| Naphcare | $16 | 155% |
| Blue Cross Blue Shield | $18 - $38 | 174% |
| Comp Alliance Workers Comp | $20 | 194% |
| Oha Networks | $22 | 213% |
| Worker Compensation | $23 | 223% |
Consumer Guidance & Cost Commentary
For the CPT code 87040, "Culture, blood," Saint John Hospital in Leavenworth, KS, lists a gross charge of $188.00. While the facility's cash median price is $10.00, commercial insurance negotiated rates typically range from $9.00 to $66.00 depending on the payer, with most plans falling between $10.00 and $23.00. This service is benchmarked against Medicare, which pays $10.32, indicating that the facility's negotiated rates are generally aligned with or slightly above the federal baseline. Patients should note that while in-network insurance often caps costs, the actual amount paid can vary significantly based on whether the patient has met their deductible or if the specific plan's negotiated rate exceeds the cash price.
To minimize out-of-pocket expenses, consumers should verify if paying cash upfront offers a lower rate than their insurance would allow, as commercial negotiated rates often include administrative overhead that can inflate the final bill. It is also important to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if the bill is settled in full before or shortly after the service. If a patient receives a bill from an out-of-network provider or encounters unexpected charges, they should request an itemized audit to identify errors or unbundled codes before making a payment, ensuring they are not balance billed for services that may be covered under federal protections.