Culture, blood
Facility: St. Catherine Hospital - Garden City
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $46
- Cash Discount Price: $93
- vs. Medicare Baseline: 4.46x 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 446% of the Medicare baseline (a markup of 346%). 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 |
|---|---|---|
| Aetna | $10 - $141 | 97% |
| Blue Cross Blue Shield | $10 - $46 | 97% |
| Humana | $10 | 97% |
| Kansas Health | $10 | 97% |
| UnitedHealthcare | $10 - $104 | 97% |
| Cigna | $10 - $13 | 97% |
| Kaiser | $10 - $82 | 97% |
| Medicare (plans) | $10 | 97% |
| Devoted Health | $10 | 97% |
| Innovage | $10 | 97% |
| Centura Employee Plan | $13 | 126% |
| United Colorado Doctor'S Plan | $15 | 145% |
| Direct To Employer | $18 - $119 | 174% |
| Denver Health | $70 | 678% |
| Peak Health | $116 | 1124% |
| Wpaa | $118 | 1143% |
| Christian Health Aid | $134 | 1298% |
| Multiplan | $151 - $254 | 1463% |
| Health Partners Of Kansas | $163 | 1579% |
Consumer Guidance & Cost Commentary
For the "Culture, blood" procedure (CPT 87040) at St. Catherine Hospital in Garden City, Kansas, the cash median price is $93.00, which is significantly lower than the facility's negotiated rates. While the facility's median negotiated rate is $46.00, this figure represents the average amount commercial insurers pay, not the maximum allowed. It is important to note that for patients with high-deductible plans, paying the cash price of $93.00 upfront can sometimes be more cost-effective than relying on insurance, as many commercial negotiated rates exceed the cash price. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When comparing this service to broader benchmarks, the facility's cash rate of $93.00 is notably higher than the state average for this procedure, which is $10.32 (Medicare amount). However, the facility's negotiated rate of $46.00 is lower than the state average of $273.00 (median paid). This discrepancy highlights the importance of understanding that commercial rates vary widely by payer; for instance, UnitedHealthcare negotiates up to $104, while Kaiser uses an internal rate that is not a typical negotiated rate. To ensure you are receiving fair pricing, it is recommended to request an itemized billing audit to confirm there are no unbundled codes or services not rendered, and to compare your specific allowed amount against the Medicare benchmark to identify any potential overcharges.