CMS Price Transparency Data

Culture, blood

Facility: University of Michigan Health - West

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $103
Cash Discount Price: $57
vs. Medicare Baseline: 9.98x Medicare

The contracted insurance negotiated median rate for a Culture, blood at University of Michigan Health - West is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 9.98x the Medicare baseline. Located in 5900 Byron Center Avenue, Sw, Wyoming, MI.

Cash / Self-Pay

$57

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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: $57 (552%)

Insurance Median: $103 (998%)

Cash: $57 (552% of Medicare)

Ins. Median: $103 (998% 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 998% of the Medicare baseline (a markup of 898%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Priority Health	$29	281%
Web Tpa	$63	610%
Aetna	$96	930%
Alliance Health & Life Ppo	$96	930%
Asr Physicians	$96	930%
Hap	$96	930%
Golden Rule Ins	$103	998%
Medica	$103	998%
Student Ins/Mega Life	$103	998%
UnitedHealthcare	$103	998%
Humana	$108	1047%
Asr Cofinity	$120	1163%
Cofinity Commercial	$120	1163%
Cofinity Weyco	$120	1163%
Core Source	$120	1163%
Epoch Group	$120	1163%
Health Partners	$120	1163%
Hlthcomp Admin	$120	1163%
Mid America	$120	1163%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $57.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87040.

Insurance In-Network Protection Plan

Contact your insurance company to confirm University of Michigan Health - West is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87040.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.