CMS Price Transparency Data

Culture, blood

Facility: Hillcrest Hospital Claremore

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $145
Cash Discount Price: $110
vs. Medicare Baseline: 14.05x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Hillcrest Hospital Claremore is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 14.05x the Medicare baseline. Located in 1202 N Muskogee Place, Claremore, OK.

Cash / Self-Pay

$110

Average discount available for prompt cash payment at this facility.

Insurance Median

$145

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: $110 (1066%)

Insurance Median: $145 (1405%)

Cash: $110 (1066% of Medicare)

Ins. Median: $145 (1405% 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 1405% of the Medicare baseline (a markup of 1305%). 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
Black Lung [6055]	$92	891%
Healthcare Highways [2210]	$92 - $145	891%
Hooray Health [8000]	$92	891%
Lucent Health [6000]	$92	891%
Oncology Patient Assistance Programs [2295]	$92	891%
Oscar Insurance Company [7005]	$92	891%
Osma Health Network [2345]	$92	891%
Healthscope Benefits [2290]	$110	1066%
UnitedHealthcare	$110 - $144	1066%
Resource One Administrators [2815]	$145	1405%
Web Tpa [2115]	$145	1405%
Beacon Health Options Behavioral Health [2890]	$158	1531%
The Kempton Group Administrators [2905]	$165	1599%
Pba [1775]	$183	1773%
Medica [2910]	$207	2006%
Employee Benefit Management Services [2445]	$268	2597%
Healthcost Solutions [2415]	$286	2771%
Healthfirst [2395]	$286	2771%
Hometown Health [2155]	$286	2771%
Mayo Clinic Health Solutions [2280]	$286	2771%
Planned Administrators Inc [2360]	$286	2771%
Trustmark [2030]	$286	2771%
Universal Fidelity [2085]	$286	2771%

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 $110.
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 Hillcrest Hospital Claremore 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.