CMS Price Transparency Data
Culture, blood
Facility: Chelsea Hospital
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $113
- Cash Discount Price: $111
- vs. Medicare Baseline: 10.95x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Chelsea Hospital is $113. 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 10.95x the Medicare baseline. Located in 775 S Main St, Chelsea, MI.
Cash / Self-Pay
$111
Average discount available for prompt cash payment at this facility.
Insurance Median
$113
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: $113 (1095%)
Cash: $111 (1076% of Medicare)
Ins. Median: $113 (1095% 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 1095% of the Medicare baseline (a markup of 995%). 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 - $13 | 58% |
| Medicaid / KanCare | $6 | 58% |
| Aetna | $10 - $80 | 97% |
| Align Senior Care | $10 | 97% |
| Angela Hospice | $10 | 97% |
| Arbor Hospice | $10 | 97% |
| Blue Care Network Advantage | $10 | 97% |
| Heartland Hospice | $10 | 97% |
| Medicare (plans) | $10 | 97% |
| Cca - Zing Health | $11 | 107% |
| UnitedHealthcare | $11 - $114 | 107% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $12 | 116% |
| U Of M Health Plan | $12 | 116% |
| Bcn Domestic | $13 | 126% |
| Blue Benefit Administrators Of Massachusetts | $13 | 126% |
| Blue Care Network | $13 | 126% |
| Blue Distinction Transplant | $13 | 126% |
| Blue Shield - Ca | $13 | 126% |
| Blue Shield - Id (Regence) | $13 | 126% |
| Blue Shield - Ny Highmark Northeastern | $13 | 126% |
| Blue Shield - Ny Highmark Western | $13 | 126% |
| Blue Shield - Pa (Highmark) | $13 | 126% |
| Blue Shield - Wa (Regence) | $13 | 126% |
| Health Choices | $13 - $113 | 126% |
| Kaiser Domestic | $13 | 126% |
| Molina Marketplace | $13 | 126% |
| Geha | $15 - $114 | 145% |
| Meritain | $15 | 145% |
| Priority Health | $15 - $16 | 145% |
| Health Cost Solutions | $16 | 155% |
| Vitalcore | $16 | 155% |
| Wellpath | $16 | 155% |
| Asr Health Benefits | $21 | 203% |
| Caresource | $21 | 203% |
| Hap | $21 - $132 | 203% |
| Varipro | $21 | 203% |
| Employee Benefit Logistic | $23 | 223% |
| Wc Accident Fund | $45 | 436% |
| Wc Advantage | $45 | 436% |
| Wc Aig | $45 | 436% |
| Wc Allied | $45 | 436% |
| Wc Amerisure | $45 | 436% |
| Wc Amtrust | $45 | 436% |
| Wc Asu Risk Mgt | $45 | 436% |
| Wc Berkley Admin | $45 | 436% |
| Wc Broadspire | $45 | 436% |
| Wc Bunch & Associates | $45 | 436% |
| Wc Ccmsi | $45 | 436% |
| Wc Emc Insurance Company | $45 | 436% |
| Wc Esis | $45 | 436% |
| Wc Fcci | $45 | 436% |
| Wc Federated | $45 | 436% |
| Wc Gallagher Bassett | $45 | 436% |
| Wc Genex Care For Ohio | $45 | 436% |
| Wc Guard Insurance Company | $45 | 436% |
| Wc Hartford | $45 | 436% |
| Wc Liberty Mutual | $45 | 436% |
| Wc Meijers | $45 | 436% |
| Wc Michigan | $45 | 436% |
| Wc Mitchell Frankenmuth | $45 | 436% |
| Wc Pma | $45 | 436% |
| Wc Sedgwick | $45 | 436% |
| Wc Sentry | $45 | 436% |
| Wc Travelers | $45 | 436% |
| Wc Tristar | $45 | 436% |
| Wc Walmart | $45 | 436% |
| Wc Zurich | $45 | 436% |
| Access Health | $113 | 1095% |
| Acclaim | $113 | 1095% |
| Administrative Concepts | $113 | 1095% |
| Allegeant | $113 | 1095% |
| Ameriben | $113 | 1095% |
| American Family | $113 | 1095% |
| American Healthcare Alliance | $113 | 1095% |
| American National | $113 | 1095% |
| American Republic | $113 | 1095% |
| Amerihealth | $113 | 1095% |
| Aultcare | $113 | 1095% |
| Automated Benefit Services | $113 | 1095% |
| Auxiant | $113 | 1095% |
| Benefit Administrative Systems,Llc | $113 | 1095% |
| Boon Chapman | $113 | 1095% |
| Cam Administrative Services | $113 | 1095% |
| Christian Brother Services | $113 | 1095% |
| Christian Brothers Holy Cross | $113 | 1095% |
| Comprehensive Benefits | $113 | 1095% |
| Continental Life Insurance | $113 | 1095% |
| Custom Benefit Administrators | $113 | 1095% |
| Employee Benefit Concepts | $113 | 1095% |
| Employee Benefit Management | $113 | 1095% |
| Enterprise Group Planning | $113 | 1095% |
| Freedom Life Insurance Company | $113 | 1095% |
| Group Administrators | $113 | 1095% |
| Group Marketing Services | $113 | 1095% |
| Guardian | $113 | 1095% |
| Health America | $113 | 1095% |
| Healthcare Management Admin | $113 | 1095% |
| Healthez | $113 | 1095% |
| Humana | $113 | 1095% |
| Insight | $113 | 1095% |
| Intercare | $113 | 1095% |
| Jfp Benefit Management | $113 | 1095% |
| Jp Farley Corporation | $113 | 1095% |
| Key Benefit Administrator | $113 | 1095% |
| Liberty Union Life Assurance Co | $113 | 1095% |
| Lucent Health | $113 | 1095% |
| Luminare Health | $113 | 1095% |
| Luminare Health (Detroit) | $113 | 1095% |
| Magnacare | $113 | 1095% |
| Medben | $113 | 1095% |
| Medcost | $113 | 1095% |
| Medical Mutual | $113 | 1095% |
| Mutual Health Services | $113 | 1095% |
| Mutual Of Omaha | $113 | 1095% |
| Ncas | $113 | 1095% |
| Nippon Life Ins | $113 | 1095% |
| Nova | $113 | 1095% |
| Painters Union Insurance Fund | $113 | 1095% |
| Physicians Mutual | $113 | 1095% |
| Plumbers Local 98 Insurance Fund | $113 | 1095% |
| Prairie States | $113 | 1095% |
| Preferred One | $113 | 1095% |
| Primary Physician Care | $113 | 1095% |
| Professional Benefit Administrators | $113 | 1095% |
| Siho Insurance Services | $113 | 1095% |
| Sisco Benefits | $113 | 1095% |
| The Loomis Company | $113 | 1095% |
| Unicare | $113 | 1095% |
| Us Health And Life | $113 | 1095% |
| Valenz | $113 | 1095% |
| Western & Southern Financial Group | $113 | 1095% |
| Wps | $113 | 1095% |
| Coventry | $116 | 1124% |
| First Health | $116 | 1124% |
| Hospice Of Michigan | $119 | 1153% |
| Cigna | $120 | 1163% |
| 1199 National Benefit Fund | $128 | 1240% |
| Allied National Global Care | $128 | 1240% |
| Asrm - Reliance Standard Life Insurance | $128 | 1240% |
| Christian Care Ministry | $128 | 1240% |
| Dean Health | $128 | 1240% |
| Fallon Health | $128 | 1240% |
| Family Life Insurance Company | $128 | 1240% |
| Ghc Scw | $128 | 1240% |
| Group Pension Administrators | $128 | 1240% |
| International Benefit Administrators | $128 | 1240% |
| Lifetime Benefit Solutions | $128 | 1240% |
| Manhattan Life | $128 | 1240% |
| Medi Share | $128 | 1240% |
| Multiplan | $128 | 1240% |
| Mvp | $128 | 1240% |
| Pai | $128 | 1240% |
| Pan-American Life | $128 | 1240% |
| Paramount Hmo | $128 | 1240% |
| Phcs | $128 | 1240% |
| Trinity Health Share | $128 | 1240% |
| Health Partners | $132 | 1279% |
| Tufts Health Plan | $132 | 1279% |
| Prime Health Services | $136 | 1318% |
| Three Rivers Provider Network | $153 | 1483% |
| Cmh Detroit Wayne Integrated Health Network | $170 | 1647% |
| Cmh Jackson County/Lifeways | $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% |