CMS Price Transparency Data

Culture, blood

Facility: St Mary's Healthcare

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $11
  • Cash Discount Price: $125
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at St Mary's Healthcare is $11. 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 1.07x the Medicare baseline. Located in 427 Guy Park Avenue, Amsterdam, NY.
Cash / Self-Pay
$125

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $11 (107%)
Cash: $125 (1211% of Medicare)
Ins. Median: $11 (107% 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.

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
Medicaid / KanCare $10 - $11 97%
Medicare (plans) $10 - $12 97%
Tricare $10 97%
UnitedHealthcare $10 97%
Va $10 97%
Aetna $11 - $136 107%
Blue Cross Blue Shield $11 - $127 107%
Humana $11 107%
Carelon_Commercial $91 882%
Carelon_Empire $91 882%
Emblem_Commercial $109 1056%
Cdphp_Commercial $127 1231%
Excellus_Commercial $135 1308%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 427 Guy Park Avenue, Amsterdam, NY 12010
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals