CMS Price Transparency Data

Culture, blood

Facility: Ochsner Stennis Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $30
Cash Discount Price: $125
vs. Medicare Baseline: 2.91x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Ochsner Stennis Memorial Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 2.91x the Medicare baseline. Located in 14365 Highway 16 West, De Kalb, MS.

Cash / Self-Pay

$125

Average discount available for prompt cash payment at this facility.

Insurance Median

$30

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: $125 (1211%)

Insurance Median: $30 (291%)

Cash: $125 (1211% of Medicare)

Ins. Median: $30 (291% 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 291% of the Medicare baseline (a markup of 191%). 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	$4 - $92	39%
Humana	$8 - $109	78%
Medicaid / KanCare	$9 - $10	87%
Cigna	$10 - $109	97%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$10 - $110	97%
Medicare (plans)	$10 - $125	97%
Primewell Health Services Commercial Exchange Plan	$10 - $121	97%
Primewell Health Services – Commercial	$10 - $121	97%
Shared Health Mississippi	$11 - $114	107%
Prime Health Services Ppo	$12 - $145	116%
Ambetter / Centene	$14 - $110	136%
Blue Cross Blue Shield	$18 - $19	174%
Cor Vel	$18	174%
Prime Health Services Ppo -Workers Comp	$18	174%
Aetna	$19 - $118	184%
Zelis	$24 - $136	233%
Claritev D/B/A Multiplan/Phcs/American Life Care	$25 - $136	242%
Select Administrative Services Network	$35 - $127	339%

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 $125.
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 Ochsner Stennis Memorial 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.