Culture, blood
Facility: Goodland Regional Medical Center
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $82
- Cash Discount Price: $82
- vs. Medicare Baseline: 7.95x 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 795% of the Medicare baseline (a markup of 695%). 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% |
| Wppa | $77 - $82 | 746% |
| UnitedHealthcare | $82 | 795% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood) at Goodland Regional Medical Center in Goodland, Kansas, the cash median price is $82.00, which is 7.9% higher than the Medicare benchmark of $10.32. While the facility offers a negotiated rate of $82.00 for in-network payers like Blue Cross Blue Shield, Wppa, and UnitedHealthcare, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that the cash median aligns with the median negotiated rate, suggesting that paying out-of-pocket directly could result in the same cost as using insurance, potentially avoiding administrative fees associated with claims processing.
Before scheduling any services, patients should explicitly request a "self-pay" or "prompt-pay" discount, as hospitals often offer fee reductions of 20% to 50% for upfront payments to improve cash flow and bypass costly billing cycles. Although the facility is a Critical Access Hospital owned by the local government, patients must be aware that balance billing could occur if ancillary services are provided by out-of-network providers, even at an in-network facility. To avoid unexpected charges, consumers should demand a full itemized bill before payment and verify that no "waiver of insurance submission" forms are signed, ensuring they are not inadvertently agreeing to pay the difference between the allowed amount and the full chargemaster rate.