CMS Price Transparency Data

Culture, blood

Facility: Salem Memorial District Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $168
  • Cash Discount Price: $158
  • vs. Medicare Baseline: 16.28x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Salem Memorial District Hospital is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 16.28x the Medicare baseline. Located in Po Box 774, Salem, MO.
Cash / Self-Pay
$158

Average discount available for prompt cash payment at this facility.

Insurance Median
$168

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: $158 (1531%)
Insurance Median: $168 (1628%)
Cash: $158 (1531% of Medicare)
Ins. Median: $168 (1628% 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 1628% of the Medicare baseline (a markup of 1528%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $20 - $246 194%
Ambetter / Centene $20 - $93 194%
Blue Cross Blue Shield $20 - $259 194%
Humana $20 - $232 194%
Tricare $20 - $93 194%
Triwest $20 - $93 194%
UnitedHealthcare $20 - $93 194%
Veteran'S Affairs $20 - $93 194%
Healthlink $38 - $177 368%
First Health $46 - $218 446%
Mercy - C.B. Management Company/Joplin Supply Company $46 - $218 446%
Mercy - City Of Springfield $46 - $218 446%
Mercy - Clayco $46 - $218 446%
Mercy - Commerce Bank $46 - $218 446%
Mercy - Diversified Plastics $46 - $218 446%
Mercy - Employers Benefit Alliance $46 - $218 446%
Mercy - Evolutions $46 - $218 446%
Mercy - Fabick Cat $46 - $218 446%
Mercy - Firsthealth Network $46 - $218 446%
Mercy - Health Management Network $46 - $218 446%
Mercy - Health Systems Inc $46 - $218 446%
Mercy - Liberty Utilities/Empire District Electric $46 - $218 446%
Mercy - Life Church $46 - $218 446%
Mercy - Missouri State University $46 - $218 446%
Mercy - Prime Health Services $46 - $218 446%
Mercy - Quiktrip Corporation $46 - $218 446%
Mercy - Shinesolar $46 - $218 446%
Mercy - Springfield Public Schools $46 - $218 446%
Mercy - Springfield Remanufacturing $46 - $218 446%
Mercy - Sumnerone $46 - $218 446%
Mercy - Trailiner $46 - $218 446%
Mercy - Walmart Mercy Accountable Care Plan $46 - $218 446%
Mercy-American Healthcare Alliance $46 - $218 446%
Phcs $46 - $232 446%
Cigna $49 - $232 475%
Mercy - Compresults $52 - $246 504%
Mercy - Corvel Corporation $52 - $246 504%
Mercy - Novasys $52 - $246 504%
Mercy - Scurlock Industries $52 - $246 504%
Mercy - Usa Managed Care Organization $52 - $246 504%
Right Choice-Alliance $55 - $259 533%
Right Choice-Regular $56 - $265 543%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Po Box 774, Salem, MO 65560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals