Culture, blood
Facility: Overland Park Reg Med Ctr
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $109
- Cash Discount Price: $830
- vs. Medicare Baseline: 10.56x 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 1056% of the Medicare baseline (a markup of 956%). 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 |
|---|---|---|
| Cigna | $5 - $11 | 48% |
| Amerigroup | $9 | 87% |
| United | $9 - $489 | 87% |
| Unicare | $10 | 97% |
| Medicaid / KanCare | $10 | 97% |
| Healthyblue | $10 | 97% |
| Devoted Health | $10 | 97% |
| Coventry | $10 - $437 | 97% |
| Humana | $10 - $25 | 97% |
| Blue Cross Blue Shield | $10 - $468 | 97% |
| Aetna | $10 - $554 | 97% |
| Home State Health Plan | $10 | 97% |
| Triwest Health Alliance | $11 | 107% |
| Pyramid Life | $11 | 107% |
| Celtic | $11 | 107% |
| Wellcare | $11 | 107% |
| Oscar | $16 | 155% |
| Multiplan | $18 - $805 | 174% |
| Corvel Corporation | $22 - $707 | 213% |
| Oha Network | $22 - $544 | 213% |
| Ambetter / Centene | $107 - $202 | 1037% |
| Nhc Advantage | $109 - $207 | 1056% |
| Wppa Providrs Care Network | $115 - $217 | 1114% |
| Universal Healthcare | $201 - $381 | 1948% |
| Coventry Kc Mo | $235 - $446 | 2277% |
| College Park Family Care Center | $246 - $468 | 2384% |
| Focus Healthcare Mgmt, Inc | $430 - $815 | 4167% |
| Cco, Inc. | $430 - $815 | 4167% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood), the Overland Park Reg Med Ctr lists a cash price of $830.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $10.32, reflecting a markup of 10.6 times the federal baseline. While commercial negotiated rates vary widely among payers—ranging from a low of $5 with Cigna to a high of $815 with Focus Healthcare Mgmt, Inc.—the cash price often serves as a critical reference point. For patients with high-deductible plans, paying the cash price of $830.00 upfront can sometimes be more cost-effective than relying on insurance, especially if the insurer's negotiated rate exceeds the cash amount or if the patient has not yet met their deductible.
To minimize costs, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these programs can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees. It is also important to verify that the facility is in-network for your specific plan, as in-network contracts establish a maximum allowed amount that protects members from balance billing, though some ancillary services may still trigger unexpected charges. Given that over 80% of hospital bills contain errors, consumers are encouraged to request a detailed, itemized statement rather than accepting a summary invoice, ensuring that all charges align with the services actually rendered.