Culture, blood
Facility: Stanton County Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $165
- Cash Discount Price: $173
- vs. Medicare Baseline: 15.99x 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 1599% of the Medicare baseline (a markup of 1499%). 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 | $36 - $165 | 349% |
| Healthy Blue Mcr Adv - All Other Plans | $170 | 1647% |
| Healthy Blue Mcaid | $173 | 1676% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood) at Stanton County Hospital, the cash price is $173.00, which matches the facility's negotiated rate for Healthy Blue Mcaid and Healthy Blue Mcr Adv. This cash price is notably higher than the state average for this service, which is $167.00, and also exceeds the Medicare benchmark of $10.32. While commercial insurance plans like Blue Cross Blue Shield have negotiated rates ranging from $36 to $165, these figures represent the maximum amounts insurers will pay, not necessarily the lowest possible cost for a patient. In cases where a patient has a high deductible or no coverage, paying the cash price of $173.00 directly may be more cost-effective than relying on insurance, as the insurer's allowed amount could still result in a higher out-of-pocket expense once deductibles and co-pays are applied.
Patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. It is important to verify that the facility is classified as self-pay before scheduling to avoid automatic claims submission that could void any cash discount agreements. Additionally, while the No Surprises Act protects patients from balance billing for emergency services at in-network facilities, patients should always request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. By comparing the facility's rates against the state average and seeking written confirmation of any discounts, patients can ensure they