CMS Price Transparency Data

Culture, blood

Facility: Fostoria Community Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $69
Cash Discount Price: $86
vs. Medicare Baseline: 6.69x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Fostoria Community Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 6.69x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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: $86 (833%)

Insurance Median: $69 (669%)

Cash: $86 (833% of Medicare)

Ins. Median: $69 (669% 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 669% of the Medicare baseline (a markup of 569%). 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
Meridian Health Plan Of Mi	$6	58%
Blue Cross Blue Shield	$10 - $86	97%
Buckeye Community Health Plan	$10 - $29	97%
Health Alliance Plan	$10 - $99	97%
Health Value Management	$10 - $28	97%
Paramount Health Care	$10 - $70	97%
Aetna	$12 - $88	116%
Buckeye Community Health Plan Inc	$12 - $48	116%
Dayton Area Health Plan Dba Caresource	$15 - $55	145%
UnitedHealthcare	$15 - $79	145%
Amerihealth	$26	252%
Veterans Affairs	$29	281%
Medical Mutual Of Ohio	$75 - $79	727%
Frontpath Health Coalition	$76	736%
Ohio Health Choice	$86	833%
Ohio Ppo Connect	$86 - $99	833%
Health Ohio Network	$104	1008%
Connecticut General Life Insurance Company	$105	1017%

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 $86.
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 Fostoria Community Hospital 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.