CMS Price Transparency Data

Culture, blood

Facility: Atlantic Rehabilitation Institute, LLC

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $129
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 12.50x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Atlantic Rehabilitation Institute, LLC is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 12.50x the Medicare baseline. Located in 200 Madison Ave, Madison, NJ.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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: $129 (1250%)
Insurance Median: $129 (1250%)
Cash: $129 (1250% of Medicare)
Ins. Median: $129 (1250% 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 1250% of the Medicare baseline (a markup of 1150%). 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 $47 - $206 455%
All Savers Cpd $47 - $206 455%
Ama Insurance Msg $47 - $206 455%
Ambetter / Centene $47 - $206 455%
Amerigroup Mgg (Wellpoint As Of 5/1/24) $47 - $206 455%
Amerihealth Cpd $47 - $206 455%
Amerihealth Mgg $47 - $206 455%
Blue Cross Blue Shield $47 - $206 455%
Braven Health Cpd $47 - $206 455%
Braven Health Mgd $47 - $206 455%
Cigna $47 - $206 455%
Claim Doc Llc Cpd $47 - $206 455%
First Managed Care Wc Cpd $47 - $206 455%
Gateway Mgg $47 - $206 455%
Medicaid / KanCare $47 - $206 455%
Oscar Health Cpd $47 - $206 455%
Oxford Health Plan Cpd $47 - $206 455%
Oxford Mgg $47 - $206 455%
Qualcare Cpd $47 - $206 455%
Qualcare Lynx Wc Cpd $47 - $206 455%
UnitedHealthcare $47 - $206 455%
Upmc For Life Mgg $47 - $206 455%
Wellcare Mgg $47 - $206 455%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Madison Ave, Madison, NJ 07940
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL