CMS Price Transparency Data

Culture, blood

Facility: Jefferson County Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $110
Cash Discount Price: $55
vs. Medicare Baseline: 10.66x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Jefferson County Hospital is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.66x the Medicare baseline. Located in Intersection Hyws 81 & 70, Waurika, OK.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$110

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: $55 (533%)

Insurance Median: $110 (1066%)

Cash: $55 (533% of Medicare)

Ins. Median: $110 (1066% 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 1066% of the Medicare baseline (a markup of 966%). 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
Medica	$6	58%
Healthcare Highways	$70 - $103	678%
Humana	$85	824%
Friday Health Plan	$92	891%
UnitedHealthcare	$107	1037%
Blue Cross Blue Shield	$110	1066%
Oklahoma Health Network (Ohn)	$126	1221%
Aetna	$134	1298%
Coventry	$134	1298%
Cigna	$142	1376%
First Health	$142	1376%
Osma Health	$142	1376%
Preferred Community Choice	$145	1405%
Healthsmart	$149	1444%

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 $55.
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 Jefferson County 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.