Culture, blood
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $10
- Cash Discount Price: $74
- vs. Medicare Baseline: 0.97x 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 - $29 | 87% |
| Smarthealth | $9 - $14 | 87% |
| Humana | $10 | 97% |
| Medicare (plans) | $10 - $11 | 97% |
| Providrs Care | $10 | 97% |
| Va | $10 | 97% |
| Aetna | $10 | 97% |
| Medicaid / KanCare | $10 | 97% |
| Ambetter / Centene | $18 | 174% |
| Blue Cross Blue Shield | $158 - $167 | 1531% |
Consumer Guidance & Cost Commentary
For the blood culture service (CPT 87040) at Ascension Via Christi Hospital Manhattan, the facility's cash median price is $74.00, which is significantly lower than the negotiated rates paid by major insurers. While UnitedHealthcare, Smarthealth, and Humana negotiate rates ranging from $9 to $29, Blue Cross Blue Shield negotiates a much higher amount between $158 and $167. This disparity highlights a common billing dynamic where commercial insurance contracts often exceed cash prices, potentially making self-pay a more affordable option for patients with high-deductible plans. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative overhead associated with insurance claims processing.
The facility's pricing is benchmarked against the federal Medicare rate of $10.32, which serves as a baseline for the true cost of care. The cash price of $74.00 represents a markup of 1.0 times the Medicare amount, indicating that the facility's pricing structure aligns closely with the government's cost basis rather than the inflated chargemaster lists often used for comparison. Given that the facility is a voluntary non-profit in Kansas (Zip 66502), patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is crucial to verify that all ancillary services, such as laboratory tests, are properly classified to avoid unexpected charges. Always review the itemized bill for any unbundled codes or services not rendered before finalizing payment.