CMS Price Transparency Data
Culture, blood
Facility: St Joe Mercy Hospital System Livonia
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $107
- Cash Discount Price: $111
- vs. Medicare Baseline: 10.37x Medicare
The contracted insurance negotiated median rate for a Culture, blood at St Joe Mercy Hospital System Livonia is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.37x the Medicare baseline. Located in 36475 Five Mile Road, Livonia, MI.
Cash / Self-Pay
$111
Average discount available for prompt cash payment at this facility.
Insurance Median
$107
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: $111 (1076%)
Insurance Median: $107 (1037%)
Cash: $111 (1076% of Medicare)
Ins. Median: $107 (1037% 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 1037% of the Medicare baseline (a markup of 937%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $6 - $10 | 58% |
| Medicaid / KanCare | $6 | 58% |
| Aetna | $10 - $75 | 97% |
| Align Senior Care | $10 | 97% |
| Angela Hospice | $10 | 97% |
| Bcn Domestic | $10 | 97% |
| Blue Benefit Administrators Of Massachusetts | $10 | 97% |
| Blue Care Network | $10 | 97% |
| Blue Care Network Advantage | $10 | 97% |
| Blue Distinction Transplant | $10 | 97% |
| Blue Shield - Ca | $10 | 97% |
| Blue Shield - Id (Regence) | $10 | 97% |
| Blue Shield - Ny Highmark Northeastern | $10 | 97% |
| Blue Shield - Ny Highmark Western | $10 | 97% |
| Blue Shield - Pa (Highmark) | $10 | 97% |
| Blue Shield - Wa (Regence) | $10 | 97% |
| Health Choices | $10 - $108 | 97% |
| Hospice Of Michigan | $10 | 97% |
| Kaiser Domestic | $10 | 97% |
| Medicare (plans) | $10 - $11 | 97% |
| Cca - Zing Health | $11 | 107% |
| UnitedHealthcare | $11 - $109 | 107% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $12 | 116% |
| U Of M Health Plan | $12 | 116% |
| Molina Marketplace | $13 | 126% |
| Priority Health | $14 - $15 | 136% |
| Geha | $15 - $109 | 145% |
| Luminare Health (Detroit) | $15 | 145% |
| Meritain | $15 | 145% |
| Health Cost Solutions | $16 | 155% |
| Vitalcore | $16 | 155% |
| Wellpath | $16 | 155% |
| Asr Health Benefits | $23 | 223% |
| Caresource | $23 | 223% |
| Employee Benefit Logistic | $23 | 223% |
| Hap | $23 - $104 | 223% |
| Varipro | $23 | 223% |
| Wc Accident Fund | $48 | 465% |
| Wc Advantage | $48 | 465% |
| Wc Aig | $48 | 465% |
| Wc Allied | $48 | 465% |
| Wc Amerisure | $48 | 465% |
| Wc Amtrust | $48 | 465% |
| Wc Asu Risk Mgt | $48 | 465% |
| Wc Berkley Admin | $48 | 465% |
| Wc Broadspire | $48 | 465% |
| Wc Bunch & Associates | $48 | 465% |
| Wc Ccmsi | $48 | 465% |
| Wc Emc Insurance Company | $48 | 465% |
| Wc Esis | $48 | 465% |
| Wc Fcci | $48 | 465% |
| Wc Federated | $48 | 465% |
| Wc Gallagher Bassett | $48 | 465% |
| Wc Genex Care For Ohio | $48 | 465% |
| Wc Guard Insurance Company | $48 | 465% |
| Wc Hartford | $48 | 465% |
| Wc Liberty Mutual | $48 | 465% |
| Wc Meijers | $48 | 465% |
| Wc Michigan | $48 | 465% |
| Wc Mitchell Frankenmuth | $48 | 465% |
| Wc Pma | $48 | 465% |
| Wc Sedgwick | $48 | 465% |
| Wc Sentry | $48 | 465% |
| Wc Travelers | $48 | 465% |
| Wc Tristar | $48 | 465% |
| Wc Walmart | $48 | 465% |
| Wc Zurich | $48 | 465% |
| Acs Benefit Services | $73 | 707% |
| Allied Benefit Systems | $73 | 707% |
| Claimchoice Adminstrators | $73 | 707% |
| Consociate | $73 | 707% |
| Cypress Benefit Administrators | $73 | 707% |
| Forest County Potawatomi | $73 | 707% |
| Health Smart | $73 | 707% |
| Healthgram | $73 | 707% |
| Healthscope | $73 | 707% |
| Secureone Preferred United Plans | $73 | 707% |
| Sisco Benefits | $73 | 707% |
| The Health Plan | $73 | 707% |
| Trustmark Small Business Benefits | $73 | 707% |
| Unified Group Services | $73 | 707% |
| Webtpa | $73 | 707% |
| Health Partners | $104 | 1008% |
| Tufts Health Plan | $104 | 1008% |
| Cigna | $106 - $136 | 1027% |
| Access Health | $108 | 1047% |
| Acclaim | $108 | 1047% |
| Administrative Concepts | $108 | 1047% |
| Allegeant | $108 | 1047% |
| Ameriben | $108 | 1047% |
| American Family | $108 | 1047% |
| American Healthcare Alliance | $108 | 1047% |
| American National | $108 | 1047% |
| American Republic | $108 | 1047% |
| Amerihealth | $108 | 1047% |
| Aultcare | $108 | 1047% |
| Automated Benefit Services | $108 | 1047% |
| Auxiant | $108 | 1047% |
| Benefit Administrative Systems,Llc | $108 | 1047% |
| Boon Chapman | $108 | 1047% |
| Cam Administrative Services | $108 | 1047% |
| Christian Brother Services | $108 | 1047% |
| Christian Brothers Holy Cross | $108 | 1047% |
| Comprehensive Benefits | $108 | 1047% |
| Continental Life Insurance | $108 | 1047% |
| Custom Benefit Administrators | $108 | 1047% |
| Employee Benefit Concepts | $108 | 1047% |
| Employee Benefit Management | $108 | 1047% |
| Enterprise Group Planning | $108 | 1047% |
| Freedom Life Insurance Company | $108 | 1047% |
| Group Administrators | $108 | 1047% |
| Group Marketing Services | $108 | 1047% |
| Guardian | $108 | 1047% |
| Health America | $108 | 1047% |
| Healthcare Management Admin | $108 | 1047% |
| Healthez | $108 | 1047% |
| Humana | $108 | 1047% |
| Insight | $108 | 1047% |
| Intercare | $108 | 1047% |
| Jfp Benefit Management | $108 | 1047% |
| Jp Farley Corporation | $108 | 1047% |
| Key Benefit Administrator | $108 | 1047% |
| Liberty Union Life Assurance Co | $108 | 1047% |
| Lucent Health | $108 | 1047% |
| Luminare Health | $108 | 1047% |
| Magnacare | $108 | 1047% |
| Medben | $108 | 1047% |
| Medcost | $108 | 1047% |
| Medical Mutual | $108 | 1047% |
| Mutual Health Services | $108 | 1047% |
| Mutual Of Omaha | $108 | 1047% |
| Ncas | $108 | 1047% |
| Nippon Life Ins | $108 | 1047% |
| Nova | $108 | 1047% |
| Painters Union Insurance Fund | $108 | 1047% |
| Physicians Mutual | $108 | 1047% |
| Plumbers Local 98 Insurance Fund | $108 | 1047% |
| Prairie States | $108 | 1047% |
| Preferred One | $108 | 1047% |
| Primary Physician Care | $108 | 1047% |
| Professional Benefit Administrators | $108 | 1047% |
| Siho Insurance Services | $108 | 1047% |
| The Loomis Company | $108 | 1047% |
| Unicare | $108 | 1047% |
| Us Health And Life | $108 | 1047% |
| Valenz | $108 | 1047% |
| Western & Southern Financial Group | $108 | 1047% |
| Wps | $108 | 1047% |
| 1199 National Benefit Fund | $109 | 1056% |
| Allied National Global Care | $109 | 1056% |
| Asrm - Reliance Standard Life Insurance | $109 | 1056% |
| Christian Care Ministry | $109 | 1056% |
| Dean Health | $109 | 1056% |
| Fallon Health | $109 | 1056% |
| Family Life Insurance Company | $109 | 1056% |
| Ghc Scw | $109 | 1056% |
| Group Pension Administrators | $109 | 1056% |
| International Benefit Administrators | $109 | 1056% |
| Lifetime Benefit Solutions | $109 | 1056% |
| Manhattan Life | $109 | 1056% |
| Medi Share | $109 | 1056% |
| Multiplan | $109 | 1056% |
| Mvp | $109 | 1056% |
| Pai | $109 | 1056% |
| Pan-American Life | $109 | 1056% |
| Paramount Hmo | $109 | 1056% |
| Phcs | $109 | 1056% |
| Trinity Health Share | $109 | 1056% |
| First Health | $111 | 1076% |
| Coventry | $136 | 1318% |
| Prime Health Services | $136 | 1318% |
| Three Rivers Provider Network | $153 | 1483% |
| Carelon Behavioral Health | $170 | 1647% |
| Cmh Detroit Wayne Integrated Health Network | $170 | 1647% |
| Cmh Lenawee County | $170 | 1647% |
| Cmh Livingston County | $170 | 1647% |
| Cmh Misc | $170 | 1647% |
| Cmh Monroe County | $170 | 1647% |
| Cmh Washtenaw County | $170 | 1647% |
| Magellan Behavioral Health | $170 | 1647% |