CMS Price Transparency Data

Culture, blood

Facility: Atrium Health Union

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $124
Cash Discount Price: $150
vs. Medicare Baseline: 12.02x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Atrium Health Union is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 12.02x the Medicare baseline. Located in 600 Hospital Dr, Monroe, NC.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

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: $150 (1453%)

Insurance Median: $124 (1202%)

Cash: $150 (1453% of Medicare)

Ins. Median: $124 (1202% 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 1202% of the Medicare baseline (a markup of 1102%). 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
Aetna	$11 - $183	107%
Cigna	$11 - $203	107%
Humana	$11	107%
UnitedHealthcare	$11 - $142	107%
Alliance	$13 - $46	126%
Amerihealth Caritas	$13 - $39	126%
Carolina Complete Health	$13 - $40	126%
Healthy Blue	$13 - $40	126%
Ortho Carolina	$13	126%
Partners	$13 - $39	126%
Trillium	$13 - $41	126%
Vaya	$13 - $40	126%
Wellcare	$13 - $40	126%
Blue Cross Blue Shield	$16 - $112	155%
Ambetter / Centene	$89 - $109	862%
Employers Health Network	$133 - $159	1289%
Medcost	$162 - $195	1570%
Magellan	$180	1744%
Gmmi	$195	1890%
Quik Trip	$195	1890%
Healthgram	$240	2326%
Choicecare	$255	2471%
First Health	$255	2471%
Beechstreet	$270	2616%
Private Health Care Systems	$270	2616%
Provider Select	$270	2616%
Multiplan	$285	2762%

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 $150.
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 Atrium Health Union 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.