CMS Price Transparency Data

Culture, blood

Facility: M Health Fairview Ridges Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $111
Cash Discount Price: $80
vs. Medicare Baseline: 10.76x Medicare

The contracted insurance negotiated median rate for a Culture, blood at M Health Fairview Ridges Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.76x the Medicare baseline. Located in 201 East Nicollet Boulevard, Burnsville, MN.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $80 (775%)

Insurance Median: $111 (1076%)

Cash: $80 (775% of Medicare)

Ins. Median: $111 (1076% 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 1076% of the Medicare baseline (a markup of 976%). 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
Blue Cross Blue Shield	$10 - $52	97%
Itasca Medical Care	$10	97%
Medica	$10 - $28	97%
Primewest	$10	97%
Sanford Health Plan	$10 - $111	97%
Security Health Plan	$10 - $141	97%
South Country Health Alliance	$10	97%
Ucare	$10 - $23	97%
UnitedHealthcare	$10 - $20	97%
Wellcare	$10	97%
Health Partners	$11 - $92	107%
Hennepin Health	$11 - $12	107%
America'S Ppo	$97 - $135	940%
First Health	$152 - $154	1473%
Multiplan	$158 - $160	1531%
Private Healthcare Systems	$158 - $160	1531%
Wisconsin Physician Services	$167 - $169	1618%

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 $80.
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 M Health Fairview Ridges Hospital 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.