Culture, blood
Facility: Centura St. Catherine-Dodge City
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $60
- Cash Discount Price: $37
- vs. Medicare Baseline: 5.81x 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 581% of the Medicare baseline (a markup of 481%). 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 |
|---|---|---|
| Kaiser | $10 | 97% |
| Medicare (plans) | $10 | 97% |
| Cigna | $10 | 97% |
| Aetna | $10 - $73 | 97% |
| Kansas Health | $10 | 97% |
| Humana | $10 | 97% |
| Blue Cross Blue Shield | $10 - $45 | 97% |
| Centura Employee Plan | $13 | 126% |
| UnitedHealthcare | $60 | 581% |
| Wpaa | $64 | 620% |
| Christian Health Aid | $73 | 707% |
| Multiplan | $73 - $82 | 707% |
| Health Partners Of Kansas | $82 | 795% |
Consumer Guidance & Cost Commentary
For this blood culture service at Centura St. Catherine-Dodge City, the cash price of $37.00 is significantly lower than the facility's gross charge of $91.00 and the median negotiated rate of $60.00. While the facility's cash rate is higher than the state of Kansas average, it remains a substantial discount compared to the full chargemaster. Patients with high-deductible plans or those without insurance may find paying cash directly offers the lowest out-of-pocket cost, as the negotiated rates for in-network payers like Aetna and Multiplan range from $10 to $82. It is important to verify your specific plan's deductible status before scheduling, as meeting your deductible could result in higher out-of-pocket costs despite the lower cash price.
To ensure you are not overcharged, always request a full itemized bill before paying, as summary bills can obscure individual line items and potential errors. If you receive a balance bill for out-of-network services, such as certain lab tests, you may be entitled to protections under the No Surprises Act, which bans balance billing for emergency and non-emergency care at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can reduce the final amount owed by 20% to 50% if settled in full within 30 days. Since over 80% of hospital bills contain errors, disputing any discrepancies in writing is the most effective way to reduce medical debt and avoid unexpected charges.