CMS Price Transparency Data
Culture, blood
Facility: St Catherine of Siena Hospital
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $10
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Culture, blood at St Catherine of Siena Hospital is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 0.97x the Medicare baseline. Located in 50 Route 25A, Smithtown, NY.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$10
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%)
Insurance Median: $10 (97%)
Ins. Median: $10 (97% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Affinity Health Plan | $8 - $19 | 78% |
| Beacon Health Options | $8 - $774 | 78% |
| Beacon Health Strategies | $8 - $14 | 78% |
| Centerlight Healthcare | $8 - $10 | 78% |
| Elderplan Inc. | $8 - $10 | 78% |
| Emblem Health | $8 - $23 | 78% |
| Fidelis Care New York | $8 - $19 | 78% |
| Health First | $8 - $23 | 78% |
| Health Plus | $8 - $19 | 78% |
| Independent Health | $8 - $10 | 78% |
| Medicaid / KanCare | $8 | 78% |
| Mvp Health Plans | $8 - $26 | 78% |
| Senior Whole Health | $8 - $10 | 78% |
| UnitedHealthcare | $8 - $38 | 78% |
| Aetna | $10 - $12 | 97% |
| Blue Cross Blue Shield | $10 - $38 | 97% |
| Centers Plan For Healthy Living | $10 | 97% |
| Healthspring | $10 | 97% |
| Liberty Health | $10 | 97% |
| Longevity Health Plan | $10 | 97% |
| Medicare (plans) | $10 - $11 | 97% |
| Orthonet - Uniformed Services Family Health Plan | $10 | 97% |
| Pmc | $10 | 97% |
| Surest | $10 | 97% |
| Tricare | $10 | 97% |
| Universal Healthcare | $10 | 97% |
| Us Family Health Plan | $10 | 97% |
| Veterans Affairs | $10 | 97% |
| Agewell New York | $11 | 107% |
| Humana | $11 | 107% |
| Partners Health Plan | $11 | 107% |
| Wellcare Health Plan Inc | $11 | 107% |
| Mail Handlers Benefit Plan | $12 | 116% |
| Meritain Health | $12 | 116% |
| Nippon Life Insurance Company Of America | $12 | 116% |
| Salvation Army | $12 | 116% |
| Zadroga | $13 | 126% |
| Centivo | $15 - $26 | 145% |
| American Plan Administrators | $23 | 223% |
| Amerihealth Administrators | $23 | 223% |
| Benefit Services | $23 | 223% |
| Ghi Cbp Ny City Employee Alternate | $23 | 223% |
| International Benefit Administrator | $23 | 223% |
| Ultra Benefits Inc. | $23 | 223% |
| Apwu | $26 | 252% |
| Brighton | $26 - $144 | 252% |
| Cigna | $26 - $133 | 252% |
| Daniel H Cook | $26 | 252% |
| Nalc | $26 | 252% |
| Samba | $26 | 252% |
| Self Pay | $38 | 368% |
| Local 1199 | $52 | 504% |
| Oscar Health | $84 | 814% |
| Allied Wellfare Fund | $133 | 1289% |
| American Group Administrators | $133 | 1289% |
| Bakery & Confectionery Union | $133 | 1289% |
| Comprehensive Benefits Consultant | $133 | 1289% |
| Guardian Life Insurance Company Of America | $133 | 1289% |
| Maloney And Assoc | $133 | 1289% |
| Multiplan | $133 | 1289% |
| Performax | $133 | 1289% |
| Phcs | $133 | 1289% |
| Pomco | $133 | 1289% |
| Tpa Inc | $133 | 1289% |
| Unicare | $133 | 1289% |
| United Employees Health Plan | $133 | 1289% |
| Coventry | $152 - $164 | 1473% |
| Magellan | $164 | 1589% |
| Galaxy | $184 | 1783% |
| Three Rivers Provider Network | $184 | 1783% |
| Aither Health | $205 | 1986% |
| Alpha Care | $205 | 1986% |
| Dentaquest | $205 | 1986% |