CMS Price Transparency Data

Culture, blood

Facility: Syracuse Area Health

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $1,253
Cash Discount Price: $1,305
vs. Medicare Baseline: 121.41x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Syracuse Area Health is $1,253. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,305. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 121.41x the Medicare baseline. Located in 2731 Healthcare Dr, Syracuse, NE.

Cash / Self-Pay

$1,305

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,253

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: $1,305 (12645%)

Insurance Median: $1,253 (12141%)

Cash: $1,305 (12645% of Medicare)

Ins. Median: $1,253 (12141% 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 12141% of the Medicare baseline (a markup of 12041%). 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
Medica	$1,148	11124%
UnitedHealthcare	$1,240	12016%
Blue Cross Blue Shield	$1,253	12141%
Midlands Choice	$1,253	12141%
Aetna	$1,266	12267%
First Health Network	$1,279	12393%

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 $1,305.
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 Syracuse Area Health 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.