CMS Price Transparency Data

Culture, blood

Facility: Alliancehealth Madill

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $85
  • Cash Discount Price: $133
  • vs. Medicare Baseline: 8.24x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Alliancehealth Madill is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 8.24x the Medicare baseline. Located in 901 S 5Th Ave, Madill, OK.
Cash / Self-Pay
$133

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

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: $133 (1289%)
Insurance Median: $85 (824%)
Cash: $133 (1289% of Medicare)
Ins. Median: $85 (824% 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 824% of the Medicare baseline (a markup of 724%). 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
Aetna $9 - $305 87%
Humana $9 - $78 87%
Medicaid / KanCare $9 87%
Node Us Dept Of Labor $13 126%
Healthchoice $14 136%
UnitedHealthcare $18 - $80 174%
Preferred Community Choice Ppo $57 552%
Blue Cross Blue Shield $58 - $85 562%
Medicare (plans) $78 756%
Node Global Health Mcr Adv $78 756%
Node Indian Health Service Managed Care $80 775%
Node Va $80 - $184 775%
Node Champva $82 795%
Tricare $82 795%
Self Pay $133 1289%
Coventry $190 1841%
Globalhealth $236 2287%
Healthcare Highways $238 2306%
Phcs $267 2587%
Multiplan $286 - $297 2771%
First Health $312 3023%
Cigna $324 3140%
Evolutions Healthcare Systems $324 3140%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 S 5Th Ave, Madill, OK 73446
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals