CMS Price Transparency Data

Culture, blood

Facility: Fairfield Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $16
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Fairfield Medical Center is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.55x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $63 (610%)
Insurance Median: $16 (155%)
Cash: $63 (610% of Medicare)
Ins. Median: $16 (155% 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
Humana $9 - $132 87%
Aetna $10 - $91 97%
Allied Benefit Systems $10 - $97 97%
Blue Cross Blue Shield $10 - $26,250 97%
Buckeye Community Health $10 - $16 97%
Caresource $10 - $16 97%
Medical Mutual $10 - $33,500 97%
Medicare (plans) $10 97%
Medigold $10 97%
Meritain Health $10 - $97 97%
Molina $10 - $17 97%
The Health Plan $10 - $96 97%
UnitedHealthcare $10 - $16 97%
Va Ccn $10 97%
Valor Health Plan $10 97%
Oscar $11 107%
Bwc $14 136%
Medicaid / KanCare $15 145%
Amerihealth Caritas Ohio $16 155%
Quality Care Partners/Ohio Ppo Connect $100 969%
The Ohio State Health Plan $107 1037%
Cigna $115 1114%
Ohio Healthy $131 1269%
Multiplan $132 1279%
Miscellaneous Plans $139 1347%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 North Ewing Street, Lancaster, OH 43130
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals