CMS Price Transparency Data

Culture, blood

Facility: Insight Hospital and Medical Center Coldwater

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $97
  • Cash Discount Price: $110
  • vs. Medicare Baseline: 9.40x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Insight Hospital and Medical Center Coldwater is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 9.40x the Medicare baseline. Located in 274 E Chicago St, Coldwater, MI.
Cash / Self-Pay
$110

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $110 (1066%)
Insurance Median: $97 (940%)
Cash: $110 (1066% of Medicare)
Ins. Median: $97 (940% 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 940% of the Medicare baseline (a markup of 840%). 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
Aetna $97 940%
Blue Cross Blue Shield $97 940%
Cofinity $97 940%
Frontpath $97 940%
Hap $97 940%
Health Alliance Plan $97 940%
Humana $97 940%
Mclaren $97 940%
Medicaid / KanCare $97 940%
Medicare (plans) $97 940%
Multi-Plan $97 940%
Paramount Elite $97 940%
Paramount Hmo $97 940%
Paramount Ppo $97 940%
Phcs $97 940%
Php Northern Indiana $97 940%
Php Of Mid Michigan $97 940%
Priority $97 940%
UnitedHealthcare $97 940%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 274 E Chicago St, Coldwater, MI 49036
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals