CMS Price Transparency Data

Culture, blood

Facility: Uh St John Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $95
  • Cash Discount Price: $145
  • vs. Medicare Baseline: 9.21x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Uh St John Medical Center is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $145. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 9.21x the Medicare baseline. Located in 29000 Center Ridge Road, Westlake, OH.
Cash / Self-Pay
$145

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $145 (1405%)
Insurance Median: $95 (921%)
Cash: $145 (1405% of Medicare)
Ins. Median: $95 (921% 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 921% of the Medicare baseline (a markup of 821%). 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
Blue Cross Blue Shield $5 - $109 48%
Aetna $10 - $25 97%
Cigna $10 - $108 97%
Devoted Health $10 97%
Humana $10 97%
Molina $10 97%
Primetime Health Plan $10 97%
Summacare $10 - $98 97%
The Health Plan $10 - $127 97%
UnitedHealthcare $10 - $60 97%
Wellcare By Allwell $10 97%
Paramount $11 107%
Perennial Advantage Of Ohio $11 107%
Valor Health Plans $11 107%
University Health Employee Plan (Contigo) $14 136%
Ambetter / Centene $19 184%
Caresource $19 184%
Medical Mutual Of Ohio $52 - $82 504%
Amish Aid Community Plan $89 862%
Amish Church Fund And Workers Aid Plan $89 862%
Buckeye Plain Ministries $89 862%
Jp Farley $91 882%
Clarity $93 901%
Christian Healthcare Ministries $96 930%
Immergrun $96 930%
Sunrise Plan Communities $96 930%
Aultcare $106 1027%
Healthsmart $125 1211%
Ohio Health Choice $125 - $174 1211%
Medical Mutual Traditional/Health Ohio $135 1308%
Beech Street $154 - $174 1492%
Ohio Preferred Network $154 - $174 1492%
First Health $160 1550%
Century Health Network $164 1589%
Private Healthcare System $166 1609%
Configurenet $174 1686%
Fortified Provider Network $174 1686%
Multiplan $174 1686%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 29000 Center Ridge Road, Westlake, OH 44145
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals