CMS Price Transparency Data

Culture, blood

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $117
  • Cash Discount Price: $175
  • vs. Medicare Baseline: 11.34x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Essentia Health St Joseph's Medical Center is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $175. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 11.34x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$175

Average discount available for prompt cash payment at this facility.

Insurance Median
$117

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: $175 (1696%)
Insurance Median: $117 (1134%)
Cash: $175 (1696% of Medicare)
Ins. Median: $117 (1134% 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 1134% of the Medicare baseline (a markup of 1034%). 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
Advocare/Security Health $10 97%
Blue Cross Blue Shield $10 - $182 97%
Blue Plus Pmap Pcc Prime $10 - $164 97%
Freedom Blue Ppo $10 97%
Healthpartners Care Msho / Mcr Adv $10 97%
Imcare Msho Pcc Prime $10 97%
Imcare Msho Ref Req $10 97%
Itasca Med Care $10 97%
Medica Advantage Solutions $10 97%
Medica Msho/Dual Solutions $10 97%
Medica Prime Solution Group $10 97%
Medicare (plans) $10 97%
Nd Va Administration $10 97%
Platinum Blue/Vantage Blue $10 97%
Primewest $10 97%
Primewest Msho $10 97%
Secure Blue Msho $10 97%
Ubh Cost Plan $10 97%
Ubh Msho $10 97%
Ucare Msho $10 97%
UnitedHealthcare $10 - $198 97%
Medica Access $82 795%
Healthpartners Care Pmap $112 1085%
Sanford Health Plan $112 - $117 1085%
Medica $165 - $184 1599%
Medica Uplan $165 1599%
Ucare $171 1657%
Wea $187 - $200 1812%
Medica Choice $189 1831%
Cigna $191 1851%
Healthpartners $191 1851%
Healthpartners Pcc Prime $191 1851%
America'S Ppo $202 1957%
Wps $216 - $218 2093%
Aetna $221 2141%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals