CMS Price Transparency Data

Culture, blood

Facility: Bailey Medical Center, LLC

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $491
Cash Discount Price: $217
vs. Medicare Baseline: 47.58x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Bailey Medical Center, LLC is $491. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $217. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 47.58x the Medicare baseline. Located in 10502 North 110Th East Avenue, Owasso, OK.

Cash / Self-Pay

$217

Average discount available for prompt cash payment at this facility.

Insurance Median

$491

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: $217 (2103%)

Insurance Median: $491 (4758%)

Cash: $217 (2103% of Medicare)

Ins. Median: $491 (4758% 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 4758% of the Medicare baseline (a markup of 4658%). 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
Healthcare Highways [2210]	$180 - $199	1744%
Hooray Health [8000]	$180	1744%
Oncology Patient Assistance Programs [2295]	$180	1744%
Oscar Insurance Company [7005]	$180	1744%
Osma Health Network [2345]	$180	1744%
Healthscope Benefits [2290]	$191	1851%
UnitedHealthcare	$191	1851%
Resource One Administrators [2815]	$199	1928%
Web Tpa [2115]	$199	1928%
The Kempton Group Administrators [2905]	$325	3149%
First Health [1375]	$365 - $592	3537%
Medica [2910]	$365	3537%
Multiplan [1680]	$365 - $592	3537%
Cigna	$368	3566%
Healthpartners [1500]	$368	3566%
National Association Of Letter Carriers [1695]	$368	3566%
Pba [1775]	$368	3566%
Healthcare Solutions [1485]	$412	3992%
Community Care [1290]	$570	5523%
Employee Benefit Management Services [2445]	$570	5523%
Fmh Benefit Services [1390]	$570	5523%
Group Resources [1455]	$570	5523%
Phcs [1780]	$570 - $592	5523%
Gilsbar [1425]	$592	5736%
Healthcost Solutions [2415]	$592	5736%
Healthfirst [2395]	$592	5736%
Healthnet [1495]	$592	5736%
Hometown Health [2155]	$592	5736%
Mayo Clinic Health Solutions [2280]	$592	5736%
Mutual Of Omaha [1685]	$592	5736%
New Era Life Insurance Company [1705]	$592	5736%
Pan American Life Insurance Co [1770]	$592	5736%
Planned Administrators Inc [2360]	$592	5736%
Trustmark [2030]	$592	5736%
Universal Fidelity [2085]	$592	5736%
Healthsmart [1505]	$614	5950%
Pending Ssi [1616]	$722	6996%

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 $217.
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 Bailey Medical Center, LLC 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.