CMS Price Transparency Data

Culture, blood

Facility: Ohiohealth Morrow County Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $49
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 4.75x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Ohiohealth Morrow County Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 4.75x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $84 (814%)
Insurance Median: $49 (475%)
Cash: $84 (814% of Medicare)
Ins. Median: $49 (475% 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 475% of the Medicare baseline (a markup of 375%). 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 - $48 48%
Medicaid / KanCare $20 - $21 194%
UnitedHealthcare $20 - $106 194%
Amerihealth Caritas - All Plans $21 203%
Humana $21 - $121 203%
Molina Exchange - All Other Plans $34 329%
Medicare (plans) $48 - $49 465%
Aetna $49 - $112 475%
Caresource Marketplace - All Other Plans $60 581%
Medical Mutual Of Ohio Marketplace $97 940%
Ohiohealthy Network - All Other Plans $97 940%
Ohiohealthy Preferred $97 940%
Medical Mutual Of Ohio Comm - All Other Plans $105 1017%
Medical Mutual Of Ohio - Admin Serv $110 1066%
Phcs - All Plans $119 1153%
Cigna $122 1182%
Multiplan - All Plans $123 1192%
Healthstar Comm - All Plans $125 1211%
Beech Street - All Plans $126 1221%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 West Marion Road, Mount Gilead, OH 43338
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals