Culture, blood
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $31
- Cash Discount Price: $23
- vs. Medicare Baseline: 3.00x 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 300% of the Medicare baseline (a markup of 200%). 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 |
|---|---|---|
| Oncology Patient Assistance Programs [2295] | $31 | 300% |
| Web Tpa [2115] | $31 | 300% |
| Lucent Health [6000] | $31 | 300% |
| Black Lung [6055] | $31 | 300% |
| Aetna | $31 | 300% |
| Blue Cross Blue Shield | $31 | 300% |
| Healthcare Highways [2210] | $31 | 300% |
| Hooray Health [8000] | $31 | 300% |
| Department Of Corrections [1340] | $38 | 368% |
| Cigna | $44 | 426% |
| American Postal Workers Union [1070] | $44 | 426% |
| Healthpartners [1500] | $44 | 426% |
| National Association Of Letter Carriers [1695] | $44 | 426% |
| Humana | $45 | 436% |
| American Healthcare [1055] | $60 | 581% |
| Administrative Concepts [1005] | $60 | 581% |
| Multiplan [1680] | $60 | 581% |
| First Health [1375] | $60 | 581% |
| Coventry Healthcare [1320] | $63 | 610% |
| Ks Disability Determination [6090] | $77 | 746% |
Consumer Guidance & Cost Commentary
For the "Culture, blood" procedure (CPT 87040) at the University Of Kansas Health System - St Francis Campus in Topeka, KS, the facility's negotiated rate is $31.00, which aligns with the lowest end of the range observed across 20 different payers. This negotiated amount is significantly lower than the facility's gross charge of $77.00, reflecting standard insurance contract caps. However, for patients with high-deductible plans, the cash price of $23.00 may be more cost-effective than the insurance negotiated rate, as paying out-of-pocket avoids the administrative overhead and potential deductibles associated with using commercial insurance. It is advisable to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts, which can further reduce the final bill before any insurance claim is processed.
When evaluating the cost of this service, it is important to compare rates against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this code is $10.32, which serves as a scientifically validated baseline for the true cost of delivery. While the facility's cash price of $23.00 is higher than the Medicare rate, it remains well below the gross charge, indicating a reasonable markup. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected ancillary services or out-of-network providers could still trigger additional charges. To ensure accuracy, consumers should request a full itemized bill to verify that no unbundled codes or services not rendered have been included in the final invoice.