CMS Price Transparency Data

Culture, blood

Facility: Lafayette Regional Health Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $222
  • Cash Discount Price: $493
  • vs. Medicare Baseline: 21.51x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Lafayette Regional Health Center is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $493. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 21.51x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$493

Average discount available for prompt cash payment at this facility.

Insurance Median
$222

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: $493 (4777%)
Insurance Median: $222 (2151%)
Cash: $493 (4777% of Medicare)
Ins. Median: $222 (2151% 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 2151% of the Medicare baseline (a markup of 2051%). 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
United $9 - $232 87%
Aetna $10 - $452 97%
Amerigroup $10 97%
Healthyblue $10 97%
Home State Health Plan $10 97%
Medicaid / KanCare $10 97%
Unicare $10 97%
Corvel Corporation $22 - $439 213%
Oha Network $22 - $258 213%
Ambetter / Centene $87 - $96 843%
Nhc Advantage $89 - $98 862%
Universal Healthcare $122 - $134 1182%
Humana $159 - $222 1541%
Blue Cross Blue Shield $178 - $516 1725%
College Park Family Care Center $202 - $222 1957%
Oscar $235 - $258 2277%
Cigna $268 - $368 2597%
Wppa Providrs Care Network $352 - $387 3411%
Multiplan $366 - $403 3547%
Coventry $375 - $412 3634%
Coventry Kc Mo $375 - $412 3634%
Cco, Inc. $399 - $439 3866%
Focus Healthcare Mgmt, Inc $423 - $464 4099%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals