CMS Price Transparency Data

Culture, blood

Facility: Mercy Hospital Southeast

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $17
  • Cash Discount Price: $226
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Mercy Hospital Southeast is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $226. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.65x the Medicare baseline. Located in 1701 Lacey St, Cape Girardeau, MO.
Cash / Self-Pay
$226

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $226 (2190%)
Insurance Median: $17 (165%)
Cash: $226 (2190% of Medicare)
Ins. Median: $17 (165% 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 - $52 87%
Aetna $10 - $223 97%
American Health Advantage Of Mo Mcr Hmo Contracted [320264] $10 97%
Blue Cross Blue Shield $10 - $331 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%
Halo Hcr Inc Hospice Contracted [320432] $10 97%
Halo Hcr Inc Hospice [20432] $10 97%
Humana $10 - $296 97%
Kindful Hospice Contracted [320434] $10 97%
Kindful Hospice [20434] $10 97%
Medicare (plans) $10 - $11 97%
Mercy Hospice Okc [20252] $10 97%
Pace Of The Ozarks Contracted [320518] $10 97%
Tricare $10 97%
UnitedHealthcare $10 - $25 97%
Provider Partners Health Plans Contracted [320450] $12 116%
United Medical Resources Contracted [320454] $12 116%
Ambetter / Centene $13 126%
Home State Health Plan Contracted [320187] $13 126%
Consociate Consolidated Health Contracted [320490] $14 - $23 136%
Auxiant Contracted [320462] $17 - $20 165%
Centivo Contracted [320505] $17 165%
Ebms Contracted [320493] $17 165%
Healthlink Contracted [320179] $17 - $271 165%
Imagine 360 Contracted [320494] $17 165%
Mercy Benefit Admin Contracted [320251] $17 - $237 165%
Yuzu Health Contracted [320521] $17 - $237 165%
Preferred Health Plan Contracted [320522] $18 174%
Reflect Health Contracted [320492] $18 174%
Hope Trust Contracted [320488] $25 242%
Cigna $28 271%
First Health Contracted [320128] $223 2161%
Health Alliance Contracted [320164] $226 2190%
Aither Health Contracted [320449] $237 2297%
Edison Health Solutions Contracted [320502] $237 2297%
Mercy Benefit Admin [20251] $237 2297%
Workers Comp [20426] $261 - $278 2529%
Multiplan Contracted [320270] $278 2694%
Private Health Care Systems Contracted [320320] $278 2694%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Lacey St, Cape Girardeau, MO 63701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals