Culture, blood
Facility: Lindsborg Community Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $135
- Cash Discount Price: $103
- vs. Medicare Baseline: 13.08x 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 1308% of the Medicare baseline (a markup of 1208%). 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 | $38 | 368% |
| Tricare | $69 | 669% |
| Coventry Mcr Adv | $70 | 678% |
| Cigna | $125 | 1211% |
| Coventry Comm-All Other Plans | $133 | 1289% |
| UnitedHealthcare | $133 | 1289% |
| Multiplan-All Plans | $137 | 1328% |
| Phcs Preferred-All Plans | $137 | 1328% |
| Century Health-All Plans | $140 | 1357% |
| Wppa-All Plans | $140 | 1357% |
| Health Partners -All Plans | $140 | 1357% |
| Coventry Wc | $140 | 1357% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood) at Lindsborg Community Hospital, the facility's cash median price of $103.00 is notably lower than the negotiated rates paid by most insurance plans, which range from $69 to $140. While the facility is a Critical Access Hospital in Kansas with a voluntary non-profit ownership structure, patients with high-deductible plans may find paying out-of-pocket cheaper than using insurance, as the cash price avoids the administrative markups inherent in commercial contracts. It is important to note that while the facility offers a cash median of $103.00, the data does not provide specific county or state average comparisons for this procedure, so patients should verify local pricing benchmarks directly with the hospital before scheduling.
Patients should be aware that insurance negotiated rates often exceed cash prices due to the costs of claims processing and contract management, which can inflate the baseline price by 20% to 40%. If you choose to use insurance, be cautious of balance billing if you receive care from out-of-network providers, though the No Surprises Act protects you from such surprise bills for emergency services and non-emergency services at in-network facilities. To ensure you receive the best possible rate, ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, always request a detailed, itemized bill before paying to avoid summary bills that may contain errors or unbundled charges, and dispute any discrepancies in writing to protect your rights.