CMS Price Transparency Data

Culture, blood

Facility: Barnes Jewish Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $190
Cash Discount Price: $181
vs. Medicare Baseline: 18.41x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Barnes Jewish Hospital is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $181. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 18.41x the Medicare baseline. Located in One Barnes-Jewish Hospital Plaza, Saint Louis, MO.

Cash / Self-Pay

$181

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $181 (1754%)

Insurance Median: $190 (1841%)

Cash: $181 (1754% of Medicare)

Ins. Median: $190 (1841% 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 1841% of the Medicare baseline (a markup of 1741%). 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
UnitedHealthcare	$11 - $224	107%
Healthscope Benefits [258]	$12 - $196	116%
Cigna	$15 - $242	145%
Aetna	$20 - $226	194%
Allied Benefits [498]	$20 - $224	194%
Consociate [478]	$20	194%
Coresource [497]	$20	194%
Fmh Benefit Service Inc [222]	$20	194%
Mail Handlers [495]	$20	194%
Sarah Bush Lincoln [636]	$20	194%
Apwu Health Plan [216]	$25	242%
Nalc Health Benefit Plan [242]	$25	242%
Priority Health [648]	$25	242%
Blue Cross Blue Shield	$32 - $263	310%
Humana	$34	329%
Mercy Behavioral Health [573]	$76	736%
Healthlink [225]	$146 - $228	1415%
Cox Health Systems Insurance Company [220]	$166 - $196	1609%
Health Alliance [224]	$166	1609%
Hope Trust [806]	$175	1696%
Med-Pay [480]	$196 - $226	1899%
Unicare [568]	$196 - $228	1899%
First Health Commercial [734]	$224	2171%
Beechstreet [551]	$226	2190%
Detego Health [868]	$226	2190%
Health Systems Inc [620]	$226	2190%
Healthcare Sol Mercy [609]	$226	2190%
Multiplan Commercial [737]	$226	2190%
Multiplan [240]	$226	2190%
Phcs [244]	$226 - $242	2190%
Preferred Health Professionals [561]	$228	2209%
Medica [661]	$242	2345%
Hfn [563]	$257	2490%

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 $181.
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 Barnes Jewish 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.