CMS Price Transparency Data

Culture, blood

Facility: Mercy Health Rehabilitation Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $130
  • Cash Discount Price: $130
  • vs. Medicare Baseline: 12.60x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Mercy Health Rehabilitation Hospital is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 12.60x the Medicare baseline. Located in 3180 Belmont Ave, Youngstown, OH.
Cash / Self-Pay
$130

Average discount available for prompt cash payment at this facility.

Insurance Median
$130

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: $130 (1260%)
Insurance Median: $130 (1260%)
Cash: $130 (1260% of Medicare)
Ins. Median: $130 (1260% 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 1260% of the Medicare baseline (a markup of 1160%). 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
Medical Mutual Nas $18 - $152 174%
Aultcare $22 - $188 213%
Multiplan $27 - $232 262%
Aetna $33 - $277 320%
Ambetter / Centene $33 - $277 320%
Blue Cross Blue Shield $33 - $277 320%
Caresource Exchange $33 - $277 320%
Cigna $33 - $277 320%
Devoted $33 - $277 320%
Highmark Ppo Commercial $33 - $277 320%
Highmark Ppo Exchange $33 - $277 320%
Humana $33 - $277 320%
Medicaid / KanCare $33 - $277 320%
Medical Mutual Exchange $33 - $277 320%
Medical Mutual Medflex $33 - $277 320%
Medical Mutual New Biz $33 - $277 320%
Medical Mutual Supermed Commercial $33 - $277 320%
Medical Mutual Traditional Commercial $33 - $277 320%
Medicare (plans) $33 - $277 320%
Molina Exchange $33 - $277 320%
UnitedHealthcare $33 - $277 320%
Upmc $33 - $277 320%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3180 Belmont Ave, Youngstown, OH 44505
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL