Culture, blood
Facility: Lmh
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $11
- Cash Discount Price: $59
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $9 - $153 | 87% |
| UnitedHealthcare | $9 - $46 | 87% |
| Haskell Indian Health Services | $10 | 97% |
| Humana | $10 | 97% |
| Cigna | $10 - $158 | 97% |
| Medicare (plans) | $10 | 97% |
| Allwell | $11 | 107% |
| Aetna | $11 - $196 | 107% |
| Ambetter / Centene | $16 | 155% |
| Non Contracted | $189 | 1831% |
| First Health | $220 | 2132% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood), the facility in Lawrence, KS, lists a cash median of $59.00, which is significantly lower than the state average of $10.32 for Medicare reimbursement. While commercial insurance plans like Cigna and Aetna have negotiated rates ranging from $10 to $196, the cash price may actually be more affordable for patients with high-deductible plans if their insurance allowed amount exceeds $59.00. It is important to note that the facility is government-owned and located in Lawrence, KS (ZIP 66044), and patients should verify their specific plan's allowed amount before assuming the cash rate is the best option.
Patients should be aware that commercial negotiated rates often include administrative overhead and can sometimes exceed cash prices due to multi-layered billing structures. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, where the provider bills you for the difference between their full chargemaster rate and what your insurance pays. To avoid these surprises, always request an itemized bill before paying, as summary invoices can obscure individual code costs. Additionally, ask the billing department about prompt-pay discounts, which can reduce your total cost by 20% to 50% if you settle the account in full upfront, bypassing the costly insurance claims cycle.