Culture, blood
Facility: Scott County Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $110
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 10.66x 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 1066% of the Medicare baseline (a markup of 966%). 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 |
|---|---|---|
| UnitedHealthcare | $9 - $116 | 87% |
| Blue Cross Blue Shield | $38 | 368% |
| Humana | $51 | 494% |
| Wppa | $73 - $1,200 | 707% |
| Aetna | $110 | 1066% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood) at Scott County Hospital in Scott City, KS, the facility's negotiated rates range from $9 to $1,200 across five insurance plans, with a median negotiated amount of $110. This commercial rate is significantly higher than the Medicare benchmark of $10.32, reflecting the typical markup found in private insurance contracts. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that cash payments are often more cost-effective than insurance claims. If you have a high-deductible plan, paying the cash price directly or utilizing a prompt-pay discount before services are rendered may result in lower out-of-pocket costs compared to the insurance negotiated rate, especially if your deductible has not yet been met.
It is important to distinguish between the facility's gross charges and the actual amounts billed to patients, as balance billing can occur if out-of-network services are provided within an in-network facility. Although the No Surprises Act protects patients from surprise bills for emergency care and non-emergency services from out-of-network providers at in-network hospitals, unexpected charges can still arise from ancillary services or billing errors. To ensure you are not overcharged, always request a full itemized bill before paying and verify that all codes correspond to services actually received. If you receive a summary bill that obscures individual line items, you have the right to demand a detailed breakdown to identify any unbundled charges or services not rendered, which is the most effective way to reduce medical debt.