Culture, blood
Facility: Greenwood County Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $79
- Cash Discount Price: $75
- vs. Medicare Baseline: 7.66x 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 766% of the Medicare baseline (a markup of 666%). 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 | $10 - $79 | 97% |
| Triwest - All Plans | $34 | 329% |
| Blue Cross Blue Shield | $36 - $38 | 349% |
| Choicecare Mcr Adv - All Plans | $39 | 378% |
| Tricare | $39 | 378% |
| Integrated Health Plan - All Plans | $70 | 678% |
| First Health - All Other Plans | $80 | 775% |
| First Health Ccn Network | $80 | 775% |
| Beech Street - All Plans | $80 | 775% |
| Preferred Hs (Coventry) - All Plans | $85 | 824% |
| Principal Health Care Inc - All Plans | $89 | 862% |
| Amerigroup Mcaid-All Plans | $94 | 911% |
| Medicaid / KanCare | $94 | 911% |
| Providrs Care/Wppa - All Plans | $141 | 1366% |
Consumer Guidance & Cost Commentary
For the CPT code 87040, "Culture, blood," Greenwood County Hospital lists a gross charge of $94.00, with a cash median of $75.00 and a median negotiated rate of $79.00. This cash price is notably lower than the facility's negotiated rates, which range from $10 to $141 across 14 different payers, including UnitedHealthcare and Triwest. When comparing these figures to the national benchmark, the cash price of $75.00 is 7.7% higher than the Medicare amount of $10.32, reflecting the standard administrative markup inherent in commercial billing. Patients with high-deductible plans may find the cash price more advantageous than the negotiated rate, as paying the lower cash median directly can sometimes result in a lower out-of-pocket cost than the insurance allowed amount, provided the patient's deductible has not yet been met.
To minimize unexpected costs, patients should proactively request a prompt-pay discount or self-pay rate before scheduling the service, as these discounts can reduce the final bill by 20% to 50%. It is also critical to avoid accepting summary bills that obscure individual charges; instead, patients should demand a full itemized audit to verify that no unbundled codes or services not rendered are included in the total. Since over 80% of hospital bills contain errors, reviewing the line-by-line statement ensures accuracy and prevents balance billing for out-of-network ancillary services, which are now protected under the No Surprises Act. By comparing the facility's rates against the Medicare benchmark and securing a prompt-pay agreement, patients can ensure they are paying a fair,