Culture, blood
Facility: Golden Valley Memorial Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $10
- Cash Discount Price: $167
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $10 | 97% |
| Home State Health | $10 | 97% |
| Humana | $10 | 97% |
| UnitedHealthcare | $10 - $18 | 97% |
| Ambetter / Centene | $12 | 116% |
Consumer Guidance & Cost Commentary
If you are paying cash for this blood culture procedure at Golden Valley Memorial Hospital, your starting point is the facility's cash median rate of $167. While this amount is higher than the facility's negotiated rate of $10, it is important to note that commercial insurance plans often pay significantly more than the cash price due to administrative overhead and contract structures. For instance, UnitedHealthcare's negotiated rate for this service is $18, and Aetna, Home State Health, and Ambetter / Centene all have negotiated rates of $10. This dynamic means that patients with high-deductible plans might save money by paying the cash rate of $167 upfront, rather than relying on insurance, especially if their deductible has not yet been met or if their plan's negotiated rate exceeds the cash price. To minimize costs, patients should explicitly ask the billing department for "self-pay" or "prompt-pay" discounts before scheduling, which can range from 20% to 50% off the listed cash rate.
In the broader context of this service, the facility's cash median of $167 is notably higher than the national average for this procedure, which is represented by the facility's gross charge of $278, though no separate state or county average was provided in the data for direct comparison. The facility operates as a Government-owned Acute Care Hospital in Clinton, Missouri, and its pricing reflects a 3-star rating and a vintage of 2026-06. While the facility's gross charge of $278 serves as the theoretical maximum list price, the actual cash rate of $167 is the standard baseline for self-pay. Patients should be aware