CMS Price Transparency Data
Culture, blood
Facility: Claiborne Memorial Medical Center
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $108
- Cash Discount Price: $133
- vs. Medicare Baseline: 10.47x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Claiborne Memorial Medical Center is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.47x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$133
Average discount available for prompt cash payment at this facility.
Insurance Median
$108
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: $133 (1289%)
Insurance Median: $108 (1047%)
Cash: $133 (1289% of Medicare)
Ins. Median: $108 (1047% 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 1047% of the Medicare baseline (a markup of 947%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $10 - $103 | 97% |
| Amerihealth Caritas La | $10 - $68 | 97% |
| Arcadian Community Mcr Hm | $10 | 97% |
| Blue Cross Blue Shield | $10 - $56 | 97% |
| Champus | $10 | 97% |
| Champva | $10 | 97% |
| Cigna | $10 - $118 | 97% |
| Community Health Solution | $10 - $68 | 97% |
| Correctcare Intergrated | $10 - $68 | 97% |
| Healthy Blue | $10 - $68 | 97% |
| Healthy Blue Dual Adv | $10 | 97% |
| Humana | $10 - $158 | 97% |
| Kaiser Foundation Health | $10 | 97% |
| Louisiana Hc Connections | $10 - $68 | 97% |
| Magellan Services | $10 - $68 | 97% |
| Medicaid / KanCare | $10 - $68 | 97% |
| Medicare (plans) | $10 | 97% |
| Peoples Health Network | $10 | 97% |
| Pyramid Claims Mcr Hmo | $10 | 97% |
| Sterling Connect 2 | $10 | 97% |
| Sterling Premier Mc Hmo | $10 | 97% |
| Superior Health Mcr Hmo | $10 | 97% |
| Tenet Mcr Hmo | $10 | 97% |
| Tricare | $10 | 97% |
| United Hc Mcr Hmo | $10 | 97% |
| UnitedHealthcare | $10 - $68 | 97% |
| Universal Hc Mcr Hmo | $10 | 97% |
| Us Dept Of Labor | $10 | 97% |
| Vantage Health Mcr Hmo | $10 | 97% |
| Windsor Sterling Mcr Hmo | $10 | 97% |
| Wps Mvh Vapc3 | $10 | 97% |
| All Savers | $13 | 126% |
| Golden Rule Ins Co | $13 | 126% |
| United Behavioral Health | $13 | 126% |
| Vantage Health Plan Inc | $13 | 126% |
| Ambetter / Centene | $15 | 145% |
| Sedgwick Claims Mgmt Serv | $34 - $142 | 329% |
| Workman'S Comp | $34 - $142 | 329% |
| Commercial Insurance | $43 - $158 | 417% |
| Meritain Health | $43 - $103 | 417% |
| Coventry Healthcare | $65 - $95 | 630% |
| Geha | $76 - $111 | 736% |
| Health Plus Of La | $76 - $118 | 736% |
| Apwu Healthplan | $81 - $118 | 785% |
| Great West Healthcare | $81 - $118 | 785% |
| Phcs | $87 - $126 | 843% |
| Ppo Plus | $87 - $126 | 843% |
| Aarp | $108 - $158 | 1047% |
| Accordia National | $108 - $158 | 1047% |
| Aflac | $108 - $158 | 1047% |
| Alameda Alliance Forhealt | $108 - $158 | 1047% |
| American Pioneer | $108 - $158 | 1047% |
| Benefit Management | $108 - $158 | 1047% |
| Benesys Inc | $108 - $158 | 1047% |
| Business Guarantor | $108 - $158 | 1047% |
| Chubb | $108 - $158 | 1047% |
| Commercial Sr. Care | $108 - $158 | 1047% |
| Employee Benefit Services | $108 - $158 | 1047% |
| Family Life Insurance Co | $108 - $158 | 1047% |
| Farm Bureau Insurance | $108 - $158 | 1047% |
| Fiserv Health Benefit | $108 - $158 | 1047% |
| Gmp | $108 - $158 | 1047% |
| Group And Pension Admin | $108 - $158 | 1047% |
| Group Resources | $108 - $158 | 1047% |
| Haik Minvielle And Grubbs | $108 - $158 | 1047% |
| Harrington Benefit Svs | $108 - $158 | 1047% |
| Health Design Plus | $108 - $158 | 1047% |
| Health Plan | $108 - $158 | 1047% |
| Healthscope Benefits | $108 - $158 | 1047% |
| Insurance Management Admi | $108 - $158 | 1047% |
| Jefferson National | $108 - $158 | 1047% |
| John Alden Health Ins | $108 - $158 | 1047% |
| John Hancock | $108 - $158 | 1047% |
| Liberty Mutual | $108 - $158 | 1047% |
| Mailhandlers Benefit Plan | $108 - $158 | 1047% |
| Manhattan Life Ins Co | $108 - $158 | 1047% |
| Mega Life And Health | $108 - $158 | 1047% |
| Msa Careguard | $108 - $158 | 1047% |
| Mutual Of Omaha | $108 - $158 | 1047% |
| Nalc Health Benefit Plan | $108 - $158 | 1047% |
| Naphcare Inc. | $108 - $158 | 1047% |
| New Era Life Ins Co | $108 - $158 | 1047% |
| Physicians Mutual | $108 - $158 | 1047% |
| Principal Financial Group | $108 - $158 | 1047% |
| Prudential Healthcare | $108 - $158 | 1047% |
| Self Pay | $108 - $158 | 1047% |
| State Farm | $108 - $158 | 1047% |
| State Farm Insurance | $108 - $158 | 1047% |
| State Mutual Insurance Co | $108 - $158 | 1047% |
| Sterling Investors Life | $108 - $158 | 1047% |
| Tower Life | $108 - $158 | 1047% |
| Transamerica Premier Ins | $108 - $158 | 1047% |
| United American | $108 - $158 | 1047% |
| United Comm Travelers | $108 - $158 | 1047% |
| United Teachers | $108 - $158 | 1047% |
| Usable Administrator | $108 - $158 | 1047% |
| Visn 16 Cfu | $108 - $158 | 1047% |
| Wausau Benefits | $108 - $158 | 1047% |
| Webtpa | $108 - $158 | 1047% |
| Wells Fargo | $108 - $158 | 1047% |
| Woodmen Of The World | $108 - $158 | 1047% |