Culture, blood
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $45
- Cash Discount Price: $15
- vs. Medicare Baseline: 4.36x 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 436% of the Medicare baseline (a markup of 336%). 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 |
|---|---|---|
| Wppa [503200056] | $32 | 310% |
| Alt Wppa [5032000964] | $32 | 310% |
| Meritain Health [503200039] | $32 - $45 | 310% |
| Alt Carelon Behavioral Health [503200905] | $38 | 368% |
| Aetna | $45 | 436% |
| Alt Meritain Health [503999911] | $45 | 436% |
| Aha-Healthcare Preferred [503200050] | $45 | 436% |
| Allied National [503999937] | $45 | 436% |
| Cigna | $45 - $60 | 436% |
| National Assn Letter Carriers [503200019] | $45 | 436% |
| Php [503200005] | $45 | 436% |
| First Health [5032000110] | $45 | 436% |
| Correct Care Solutions [50311253] | $52 | 504% |
| Workers Comp [503999901] | $64 | 620% |
| Usa Managed Care [503999030] | $68 | 659% |
Consumer Guidance & Cost Commentary
For this blood culture service at the University of KS Health System Great Bend Campus, the facility's cash price of $15.00 is significantly lower than the state average, which sits at $45.00. While many commercial payers negotiate rates between $45.00 and $68.00, patients with high-deductible plans may find the cash rate more affordable if their insurance allowed amount exceeds this figure. It is important to note that commercial negotiated rates often include administrative overhead and contract premiums, making them higher than the direct cash price even though they protect in-network members from the full chargemaster gross of $75.00.
To ensure you receive the most accurate billing, always request an itemized bill before paying, as summary invoices can obscure individual charges or unbundled codes that should be consolidated. If you receive a balance bill for the difference between the provider's rate and your insurance payment, remember that the No Surprises Act protects you from surprise out-of-network charges for emergency care and non-emergency services at in-network facilities. Additionally, you should inquire about prompt-pay discounts, which can reduce your total cost by 20% to 50% if settled upfront, effectively bypassing the administrative costs associated with insurance claims processing.