Culture, blood
Facility: Norton County Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $54
- Cash Discount Price: $62
- vs. Medicare Baseline: 5.23x 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 523% of the Medicare baseline (a markup of 423%). 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 | $54 | 523% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood) at Norton County Hospital in Norton, KS, the cash median price is $62.00, which is lower than the facility's negotiated rate of $54.00 and significantly below the state average of $88.00. This service is provided by a Critical Access Hospital owned by the local government, and while Blue Cross Blue Shield has a single plan with a negotiated rate of $54.00, patients with high-deductible plans may find paying the cash price of $62.00 more cost-effective if their insurance allowed amount exceeds this figure. Since the facility is a Critical Access Hospital, patients should verify whether "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can further reduce the final cost.
It is important to understand that commercial negotiated rates often include administrative overhead and do not represent the lowest possible price for a patient. While the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized bill to ensure no unbundled codes or services not rendered are included. Given that over 80% of hospital bills contain errors, consumers are advised to dispute any discrepancies in writing rather than accepting summary bills. Furthermore, comparing the facility's pricing to the Medicare benchmark of $10.32 reveals the true cost baseline, showing that the cash price of $62.00 is approximately six times the Medicare rate, which helps contextualize the facility's pricing structure against federal standards.