CMS Price Transparency Data

Culture, blood

Facility: Arnot Ogden Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $147
Cash Discount Price: $53
vs. Medicare Baseline: 14.24x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Arnot Ogden Medical Center is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 14.24x the Medicare baseline. Located in 600 Roe Avenue, Elmira, NY.

Cash / Self-Pay

$53

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $53 (514%)

Insurance Median: $147 (1424%)

Cash: $53 (514% of Medicare)

Ins. Median: $147 (1424% 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 1424% of the Medicare baseline (a markup of 1324%). 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
Empire	$5	48%
Aetna	$10 - $194	97%
Amerihealth Mcr Adv - All Plans	$10	97%
Blue Cross Blue Shield	$10 - $769	97%
Fidelis	$10 - $12	97%
Humana	$10 - $240	97%
Tricare	$10	97%
Geisinger	$11 - $155	107%
Icircle	$12	116%
UnitedHealthcare	$12 - $266	116%
Amerihealth	$14	136%
Fidelis Care-Exchange - All Plans	$139	1347%
Geisinger - All Plans	$147	1424%
Cigna	$158	1531%
Mvp Health Plan - All Plans	$158	1531%
Independent Health - All Plans	$165	1599%
Upmc Health Plan - All Plans	$175	1696%
Pomco Inc - All Plans	$182	1764%
Emblem Health - All Plans	$223	2161%
Emblem/Ghi	$234	2267%
Martins Point Mcr Adv - All Plans	$253	2452%
Healthnow - All Plans	$763	7393%

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 $53.
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 Arnot Ogden Medical Center 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.