CMS Price Transparency Data

Culture, blood

Facility: Mosaic Life Care at St Joseph

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $47
Cash Discount Price: $128
vs. Medicare Baseline: 4.55x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Mosaic Life Care at St Joseph is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 4.55x the Medicare baseline. Located in 5325 Faraon Street, Saint Joseph, MO.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $128 (1240%)

Insurance Median: $47 (455%)

Cash: $128 (1240% of Medicare)

Ins. Median: $47 (455% 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 455% of the Medicare baseline (a markup of 355%). 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
Aetna	$9 - $124	87%
Medicaid / KanCare	$9	87%
UnitedHealthcare	$9 - $212	87%
Amerigroup Of Iowa	$10 - $15	97%
Iowa Total Care	$10 - $15	97%
Molina Of Iowa	$10 - $15	97%
Blue Cross Blue Shield	$11 - $130	107%
Centurion	$17 - $105	165%
Geha Shared Services	$19 - $122	184%
Ambetter / Centene	$20	194%
Cigna	$21 - $132	203%
Freedom Select Healthlink	$21 - $129	203%
Healthlink Open Access	$21 - $129	203%
Preferred Health Professional	$21 - $129	203%
Sisco	$21 - $129	203%
Multiplan	$47 - $135	455%
Home State Of Missouri	$218	2112%
Healthy Blue Of Missouri	$267	2587%

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 $128.
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 Mosaic Life Care at St Joseph 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.