Culture, blood
Facility: Cheyenne County Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $55
- Cash Discount Price: $58
- vs. Medicare Baseline: 5.33x 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 533% of the Medicare baseline (a markup of 433%). 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 |
|---|---|---|
| UnitedHealthcare | $6 - $58 | 58% |
| Blue Cross Blue Shield | $38 | 368% |
| First Health - All Plans | $41 | 397% |
| Healthy Blue Mcr Adv | $42 | 407% |
| Choice Care - All Plans | $42 | 407% |
| Aetna | $42 - $55 | 407% |
| Tricare | $42 | 407% |
| Firstguard - All Plans | $47 | 455% |
| Wppa - All Plans | $53 | 514% |
| Cpm - All Plans | $55 | 533% |
| Preferred Hc - All Plans | $55 | 533% |
| Midlands Choice - All Plans | $57 | 552% |
| Health Partners - All Plans | $57 | 552% |
| Integrated Hp - All Plans | $57 | 552% |
| Ppo Next - All Plans | $57 | 552% |
| Unicare - All Plans | $57 | 552% |
| Healthy Blue Mcaid - All Other Plans | $58 | 562% |
| Childrens Mercy - All Plans | $58 | 562% |
| Healthwave Mcaid - All Plans | $58 | 562% |
| Providers Care-All Plans | $88 | 853% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood), Cheyenne County Hospital in St. Francis, KS, lists a cash price of $58.00, which matches the facility's negotiated median and the highest cash rate among payers. This cash price is significantly higher than the Medicare benchmark of $10.32, indicating a markup of 5.3 times the federal rate. While commercial payers negotiate rates ranging from $6 to $88, the cash price remains the lowest option for patients without insurance coverage. It is important to note that for patients with high-deductible plans, paying the cash price of $58.00 upfront may be more cost-effective than relying on insurance, as many commercial negotiated rates exceed this amount. Patients should verify their specific plan's deductible status and ask the hospital directly about self-pay or prompt-pay discounts before scheduling the test.
This service is provided at a Critical Access Hospital in a rural area, where pricing dynamics can differ from urban centers. The facility is a voluntary non-profit organization, and while the data does not include a specific facility rating, the wide variance in payer rates—from a low of $6 with UnitedHealthcare to a high of $88 with Providers Care—highlights the importance of checking individual plan details. Commercial rates generally reflect administrative costs and contract terms that can inflate prices beyond the true cost of service, which is anchored by the Medicare rate. To ensure you are receiving fair pricing, always request an itemized bill to review specific CPT codes and avoid paying for services not rendered or charges that may be unbundled. If you receive a summary bill, insist on a full line-by-line statement to identify