CMS Price Transparency Data
Culture, blood
Facility: Mercy Hospital St Louis
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $14
- Cash Discount Price: $177
- vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Mercy Hospital St Louis is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.36x the Medicare baseline. Located in 615 New Ballas Road, Saint Louis, MO.
Cash / Self-Pay
$177
Average discount available for prompt cash payment at this facility.
Insurance Median
$14
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: $177 (1715%)
Insurance Median: $14 (136%)
Cash: $177 (1715% of Medicare)
Ins. Median: $14 (136% 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.
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 |
|---|---|---|
| Medicaid / KanCare | $9 - $41 | 87% |
| Aetna | $10 - $68 | 97% |
| American Health Advantage Of Mo Mcr [10473] | $10 | 97% |
| Blue Cross Blue Shield | $10 - $246 | 97% |
| Cherokee Nation Health Serv Contracted [320066] | $10 | 97% |
| Cigna | $10 - $123 | 97% |
| Cross Timbers Hospice [20098] | $10 | 97% |
| Dept Of Veteran Affairs Contracted [320106] | $10 | 97% |
| Elara Caring Aspire Hospice Contracted [320433] | $10 | 97% |
| Elara Caring Aspire Hospice [20433] | $10 | 97% |
| Globalhealth Contracted [320145] | $10 | 97% |
| Halo Hcr Inc Hospice Contracted [320432] | $10 | 97% |
| Halo Hcr Inc Hospice [20432] | $10 | 97% |
| Humana | $10 | 97% |
| Kindful Hospice Contracted [320434] | $10 | 97% |
| Kindful Hospice [20434] | $10 | 97% |
| Medicare (plans) | $10 - $273 | 97% |
| Mercy Hospice Okc [20252] | $10 | 97% |
| Pace Of The Ozarks Contracted [320518] | $10 | 97% |
| Qual Choice Contracted [320325] | $10 | 97% |
| Tricare | $10 | 97% |
| UnitedHealthcare | $10 - $12 | 97% |
| Provider Partners Health Plans Contracted [320450] | $11 | 107% |
| United Medical Resources Contracted [320454] | $12 | 116% |
| Healthscope Contracted [320182] | $13 | 126% |
| Aither Health Contracted [320449] | $14 | 136% |
| Aither Health [20449] | $14 | 136% |
| Auxiant Contracted [320462] | $14 | 136% |
| Ebms Contracted [320493] | $14 | 136% |
| Edison Health Solutions Contracted [320502] | $14 | 136% |
| Healthlink Contracted [320179] | $14 - $186 | 136% |
| Imagine 360 Contracted [320494] | $14 | 136% |
| Medica Contracted [320239] | $14 | 136% |
| Mercy Benefit Admin Contracted [320251] | $14 - $17 | 136% |
| Mercy Benefit Admin [20251] | $14 - $17 | 136% |
| Reflect Health Contracted [320492] | $14 | 136% |
| Show-Me Health Administrators Contracted [320483] | $14 | 136% |
| Yuzu Health Contracted [320521] | $14 | 136% |
| Ambetter / Centene | $17 | 165% |
| Centivo Contracted [320505] | $17 | 165% |
| Home State Health Plan Contracted [320187] | $17 | 165% |
| Novasys Contracted [320285] | $17 | 165% |
| Preferred Health Plan Contracted [320522] | $18 | 174% |
| Hope Trust Contracted [320488] | $23 | 223% |
| Health Choices Contracted [320448] | $164 | 1589% |
| Health Choices [20448] | $164 | 1589% |
| Medical Associates Health Contracted [320444] | $164 | 1589% |
| Federal Medical Center Contracted [320127] | $177 | 1715% |
| Insurance System Inc Contracted [320465] | $177 | 1715% |
| Point C Contracted [320238] | $177 | 1715% |
| Tri State Healthcare Coalition Contracted [320379] | $177 | 1715% |
| First Health Contracted [320128] | $191 - $194 | 1851% |
| Mercy Mgd Behavioral Health Contracted [320259] | $191 | 1851% |
| Multiplan Contracted [320270] | $191 - $205 | 1851% |
| Private Health Care Systems Contracted [320320] | $191 | 1851% |
| Workers Comp [20426] | $205 - $218 | 1986% |