Culture, blood
Facility: Stevens County Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $38
- Cash Discount Price: $90
- vs. Medicare Baseline: 3.68x 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 368% of the Medicare baseline (a markup of 268%). 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 |
|---|---|---|
| Aetna | $9 - $90 | 87% |
| Humana | $33 | 320% |
| Blue Cross Blue Shield | $36 - $38 | 349% |
| First Health - All Plans | $81 | 785% |
| Wppa - All Plans | $86 | 833% |
| Medicaid / KanCare | $90 | 872% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood) at Stevens County Hospital in Hugoton, Kansas, the cash median price is $90.00, which matches the facility's gross charge. This rate is significantly lower than the state and county averages, offering a transparent pricing structure for self-pay patients. While commercial payers like Aetna and Blue Cross Blue Shield have negotiated rates ranging from $9 to $90, the cash price remains the most predictable option for those without insurance. Patients with high-deductible plans may find this cash rate advantageous, as it avoids the administrative markups often embedded in commercial negotiated rates. It is important to note that while Medicaid/KanCare and First Health - All Plans also pay the full $90.00, self-pay patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the lowest possible fee.
The facility's pricing for this service is benchmarked against the Medicare rate of $10.32, revealing a substantial markup typical of commercial billing structures. Although the negotiated rates for commercial plans average $38.00, which is lower than the cash price, patients must be aware that these rates are often subject to deductibles and copays that can exceed the cash amount. To minimize costs, consumers should verify their deductible status before relying on insurance and consider paying the cash price directly if their out-of-pocket expenses are likely to be higher. Additionally, patients should request an itemized bill to ensure no unbundled charges or services not rendered are included, as summary bills can obscure the true cost of care. By comparing the facility's rates directly to the Medicare baseline and seeking prompt-pay