CMS Price Transparency Data

Culture, blood

Facility: Sanford Tracy Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $156
Cash Discount Price: $150
vs. Medicare Baseline: 15.12x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Sanford Tracy Medical Center is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 15.12x the Medicare baseline. Located in 251 Fifth Street East, Tracy, MN.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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: $150 (1453%)

Insurance Median: $156 (1512%)

Cash: $150 (1453% of Medicare)

Ins. Median: $156 (1512% 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 1512% of the Medicare baseline (a markup of 1412%). 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	$45 - $173	436%
Sanford Health Plan Align	$73	707%
Ucare	$78 - $164	756%
Wellmark Sd	$78	756%
Aetna	$79 - $162	766%
Health Partners	$79 - $150	766%
Medicare (plans)	$79	766%
UnitedHealthcare	$79 - $156	766%
Primewest	$80 - $91	775%
Security Health Plan	$103	998%
Sanford Health Plan	$148 - $174	1434%
Medica	$164 - $177	1589%
Cigna	$168	1628%
First Choice Health Network	$168	1628%
Healthez	$168	1628%
Multiplan	$168	1628%

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 $150.
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 Sanford Tracy Medical Center 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.