Culture, blood
Facility: Hodgeman County Health Center
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $92
- Cash Discount Price: $104
- vs. Medicare Baseline: 8.91x 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 891% of the Medicare baseline (a markup of 791%). 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 - $38 | 349% |
| Humana | $83 | 804% |
| UnitedHealthcare | $83 - $124 | 804% |
| Medicaid / KanCare | $83 - $130 | 804% |
| Triwest - All Plans | $83 | 804% |
| Aetna | $104 | 1008% |
| First Health - All Plans | $117 | 1134% |
| Wppa (Provdrscare) - All Plans | $124 | 1202% |
| Health Partners - All Plans | $124 | 1202% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood) at Hodgeman County Health Center in Jetmore, KS, the cash median price is $104.00, which is lower than the facility's negotiated rates with most major payers. While the facility is a Critical Access Hospital with government-local ownership, patients should be aware that insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. For instance, UnitedHealthcare and Medicaid/KanCare have negotiated ranges starting at $83 but extending up to $124 and $130 respectively, meaning paying cash upfront could result in immediate savings compared to standard insurance billing. Additionally, the facility offers a prompt-pay discount for upfront payments, which can further reduce the final amount owed by bypassing the costly insurance claims processing cycle.
When evaluating this price, it is important to compare it against the Medicare benchmark rather than the hospital's gross chargemaster, as Medicare rates represent a scientifically validated baseline for the true cost of care. The Medicare amount for this service is $10.32, and the facility's cash rate of $104.00 is approximately 8.9 times higher than the Medicare amount, reflecting the typical markup found in commercial pricing. To ensure you are receiving the best possible rate, we recommend requesting an itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. Finally, always confirm your deductible status before scheduling, as paying the negotiated rate without meeting your deductible may result in higher out-of-pocket costs than paying the cash price directly.