Culture, blood
Facility: Ashland Health Center
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $69
- Cash Discount Price: $66
- vs. Medicare Baseline: 6.69x 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 669% of the Medicare baseline (a markup of 569%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $18 - $37 | 174% |
| Compalliance-All Plans | $44 - $88 | 426% |
| Health Partners Of Kansas-All Plans | $47 - $94 | 455% |
| Multiplan-All Plans | $54 - $108 | 523% |
| Health Choice-All Plans | $55 - $110 | 533% |
| UnitedHealthcare | $55 - $110 | 533% |
| Medicaid / KanCare | $55 - $110 | 533% |
| Medicare (plans) | $55 - $110 | 533% |
| Medica Mcare - All Plans | $55 - $110 | 533% |
| Aetna | $55 - $110 | 533% |
| Healthy Blue Mcr Adv - All Other Plans | $55 - $110 | 533% |
| Providers Care (Wppa)-All Plans | $82 - $165 | 795% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood) at Ashland Health Center in Ashland, KS, the facility's cash median price is $66.00, which is lower than the negotiated rates paid by most major insurers. While the facility's cash rate is 6.7% higher than the Medicare benchmark of $10.32, commercial insurance plans typically pay significantly more, ranging from $44 to $165 depending on the carrier. For example, Blue Cross Blue Shield pays a low of $18, whereas Providers Care pays up to $165. Because commercial negotiated rates often exceed cash prices, patients with high-deductible plans may save money by paying the cash rate directly, provided they verify that the insurance allowed amount does not exceed $66.00.
To minimize unexpected costs, patients should proactively ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the bill. It is also critical to request a full itemized billing audit rather than accepting a summary bill, since over 80% of hospital bills contain errors such as double-billing or unbundled codes that can inflate the total. If a patient receives a balance bill for an out-of-network service at this Critical Access Hospital, they should not pay immediately out of fear of credit damage; instead, they should dispute the charge with their insurer and request a No Surprises Act audit to ensure they are not liable for the difference between the provider's chargemaster rate and the insurance allowed amount.