Culture, blood
Facility: University Of Kansas Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $157
- Cash Discount Price: $45
- vs. Medicare Baseline: 15.21x 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 1521% of the Medicare baseline (a markup of 1421%). 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 |
|---|---|---|
| Larned State Hospital [503200090] | $66 | 640% |
| Workers Comp [503999901] | $82 - $213 | 795% |
| Health Plan Inc [503999941] | $105 | 1017% |
| Alt Carelon Behavioral Health [503200905] | $112 | 1085% |
| Accarent Health [503999034] | $112 | 1085% |
| Allied National [503999937] | $134 | 1298% |
| Php [503200005] | $134 - $166 | 1298% |
| Inter-Americas Insurance [503999032] | $136 | 1318% |
| Geha [503200036] | $136 | 1318% |
| Alt Wppa [5032000964] | $136 | 1318% |
| Cerner [503200038] | $136 | 1318% |
| Healthlink [503200007] | $136 - $166 | 1318% |
| Med-Pay [503200040] | $136 | 1318% |
| Cigna | $142 - $179 | 1376% |
| Aha-Healthcare Preferred [503200050] | $148 | 1434% |
| First Health [5032000110] | $148 | 1434% |
| Blue Cross Blue Shield | $155 - $172 | 1502% |
| Ascension Living Hope [503201517] | $157 | 1521% |
| Correct Care Solutions [50311253] | $157 | 1521% |
| Consolidated Billing [50311256] | $157 | 1521% |
| Coeur Plan Services [503301517] | $157 | 1521% |
| Orscheln Industries [503201608] | $168 | 1628% |
| Alt Lineco [5032000976] | $172 | 1667% |
| Empire Plan/Nyship [503200705] | $172 | 1667% |
| Alt Lucent Health Solutions [503202603] | $172 | 1667% |
| Century Health Solutions [503200054] | $179 | 1734% |
| Quiktrip [5032000412] | $179 | 1734% |
| Point Comfort Underwriters [503200018] | $179 | 1734% |
| Meritain Health [503200039] | $188 | 1822% |
| Wppa [503200056] | $188 | 1822% |
| Plan Care America [503999026] | $202 | 1957% |
| Three Rivers Provider Network [503999029] | $202 | 1957% |
| Sanford Health Plan [503999027] | $202 | 1957% |
| Usa Managed Care [503999030] | $202 | 1957% |
| Employers Health Network [503999025] | $202 | 1957% |
Consumer Guidance & Cost Commentary
For the CPT code 87040, "Culture, blood," University of Kansas Hospital in Kansas City, KS, lists a gross charge of $224.00. While the facility's cash median price is $45.00, commercial insurance negotiated rates range from $66.00 to $202.00 depending on the payer, with a median negotiated rate of $157.00. This negotiated rate is significantly higher than the cash price, illustrating that patients with high-deductible plans or those unable to use insurance may save money by paying the cash rate directly. It is important to note that the facility is a government-owned acute care hospital, and patients should verify their specific plan's allowed amount before scheduling to ensure they are not subject to higher out-of-network costs or balance billing, which is generally prohibited for in-network services at this facility.
When comparing pricing benchmarks, the facility's cash rate of $45.00 is notably lower than the Medicare amount of $10.32, suggesting a potential discrepancy in how the cash rate is calculated or reported relative to federal standards. However, the median negotiated rate of $157.00 is substantially higher than the Medicare amount, reflecting the typical administrative markup and contract dynamics where commercial rates often exceed federal benchmarks. Patients should be aware that while the facility offers a cash rate, the actual amount paid will depend on whether they utilize insurance, meet their deductible, and qualify for any prompt-pay discounts by paying upfront. Always request an itemized bill and confirm the specific allowed amount with the billing department to avoid unexpected charges.