CMS Price Transparency Data

Culture, blood

Facility: Rehabilitation Hospital Of Overland Park

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $241
  • Cash Discount Price: $321
  • vs. Medicare Baseline: 23.35x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Rehabilitation Hospital Of Overland Park is $241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 23.35x the Medicare baseline. Located in 5100 Indian Creek Pkwy, Overland Park, KS.
Cash / Self-Pay
$321

Average discount available for prompt cash payment at this facility.

Insurance Median
$241

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$10.32

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.32 (100%)
Cash / Self-Pay: $321 (3110%)
Insurance Median: $241 (2335%)
Cash: $321 (3110% of Medicare)
Ins. Median: $241 (2335% of 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 2335% of the Medicare baseline (a markup of 2235%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $192 1860%
Americas Choice Provider Network $225 2180%
Quiktrip Corporation $241 2335%
Provider Network Of America $241 2335%
Velocity $241 2335%
Usa Managed Care Organization $241 2335%
Multiplan-Phcs $257 2490%
Prime Health Services $273 2645%
Medincrease $289 2800%

Consumer Guidance & Cost Commentary

For the CPT code 87040 (Culture, blood), the Rehabilitation Hospital Of Overland Park lists a cash price of $321.00, which matches the facility's median cash rate. While this cash price is higher than the state average of $10.32, it is important to note that commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. In this case, the median negotiated rate across nine payers is $241.00, which is lower than the cash price. Patients with high-deductible plans or those who have already met their deductible may find that paying the cash rate of $321.00 is more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the patient's plan has not yet covered the service.

To minimize unexpected costs, patients should verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, if a patient receives an itemized bill, they should request a full line-by-line audit to identify any errors, such as unbundled codes or services not rendered, as over 80% of hospital bills contain inaccuracies. While the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their statement carefully to ensure all charges align with their contracted rates and avoid signing away rights to dispute out-of-network ancillary services without understanding the implications.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5100 Indian Creek Pkwy, Overland Park, KS 66207
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL