CMS Price Transparency Data
Culture, blood
Facility: St Charles Medical Center - Bend
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $48
- Cash Discount Price: $294
- vs. Medicare Baseline: 4.65x Medicare
The contracted insurance negotiated median rate for a Culture, blood at St Charles Medical Center - Bend is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $294. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 4.65x the Medicare baseline. Located in 2500 Ne Neff Road, Bend, OR.
Cash / Self-Pay
$294
Average discount available for prompt cash payment at this facility.
Insurance Median
$48
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: $294 (2849%)
Insurance Median: $48 (465%)
Cash: $294 (2849% of Medicare)
Ins. Median: $48 (465% 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 465% of the Medicare baseline (a markup of 365%). 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 |
|---|---|---|
| Advanced Health [534] | $8 | 78% |
| Allcare Health Plan [538] | $8 | 78% |
| Cascade Health Alliance [532] | $8 | 78% |
| Columbia Pacific Coordinated Care Llc [539] | $8 | 78% |
| Health Share Care Oregon [526] | $8 | 78% |
| Health Share Kaiser [543] | $8 | 78% |
| Health Share Ohsu Ohp [552] | $8 | 78% |
| Health Share Providence [548] | $8 | 78% |
| Health Share Tuality [549] | $8 | 78% |
| Health Share [537] | $8 | 78% |
| Intercommunity Health [530] | $8 | 78% |
| Jackson Care Connect [542] | $8 | 78% |
| Medicaid / KanCare | $8 | 78% |
| Primary Health Of Jospehine County Llc [547] | $8 | 78% |
| Umpqua Health [533] | $8 | 78% |
| Willamette Valley Community Health [536] | $8 | 78% |
| Yamhill County Coordinated Care Org [550] | $8 | 78% |
| Pacificsource Community Solutions [525] | $9 | 87% |
| Tricare | $9 | 87% |
| Aetna | $10 - $120 | 97% |
| Ageright Advantage [142] | $10 | 97% |
| Champ Va [700] | $10 | 97% |
| Cigna | $10 - $87 | 97% |
| Devoted Health Inc [145] | $10 | 97% |
| Health Market Care Assured [134] | $10 | 97% |
| Health Net Med Adv [135] | $10 | 97% |
| Home Health And Hospice [361] | $10 | 97% |
| Humana | $10 | 97% |
| Indian Health [704] | $10 | 97% |
| Kaiser Permanente Med Adv [136] | $10 | 97% |
| Law Enforcement [701] | $10 - $68 | 97% |
| Medicare (plans) | $10 - $12 | 97% |
| Samaritan Health Plan Med Adv [141] | $10 | 97% |
| Unicare [133] | $10 | 97% |
| UnitedHealthcare | $10 - $127 | 97% |
| Veterans [706] | $10 | 97% |
| Wellcare [132] | $10 | 97% |
| Blue Cross Blue Shield | $11 - $37 | 107% |
| Otj Dept Of Labor Federal Emp [652] | $13 | 126% |
| Otj Us Department Of Labor [669] | $13 | 126% |
| Kaiser Permanente [334] | $19 - $119 | 184% |
| Moda [310] | $21 - $118 | 203% |
| Providence Health Plan [347] | $21 - $120 | 203% |
| Bridgespan [342] | $31 | 300% |
| Asuris Northwest Health [202] | $37 | 359% |
| Healthcare Management Admin [201] | $37 | 359% |
| Regence Group Administrators [203] | $37 | 359% |
| Generic Workers Comp [699] | $48 | 465% |
| Otj Broadspire Services [670] | $48 | 465% |
| Otj Ccmsi [618] | $48 | 465% |
| Otj Chartis Claims [650] | $48 | 465% |
| Otj City County Ins Services [662] | $48 | 465% |
| Otj Corvel [676] | $48 | 465% |
| Otj Esis West Wc Claims [653] | $48 | 465% |
| Otj Gallagher Bassett [654] | $48 | 465% |
| Otj Hartford [655] | $48 | 465% |
| Otj Intermountain Claims Inc [666] | $48 | 465% |
| Otj Liberty Mutual Wausau Underwriters [671] | $48 | 465% |
| Otj Penser No American [663] | $48 | 465% |
| Otj Pinnacle Risk Mgmt [661] | $48 | 465% |
| Otj Saif [659] | $48 | 465% |
| Otj Saif [667] | $48 | 465% |
| Otj Sedgwick Cms [660] | $48 | 465% |
| Otj Sedgwick [668] | $48 | 465% |
| Otj Travelers Insurance [672] | $48 | 465% |
| Otj Tristar [673] | $48 | 465% |
| Pacificsource [345] | $55 - $75 | 533% |
| Us Benefits [326] | $87 | 843% |
| Rocky Mountain Administrators [405] | $110 | 1066% |
| Rx Internal [4100003] | $112 | 1085% |
| First Choice Health [317] | $119 | 1153% |
| Samaritan [376] | $119 | 1153% |
| Meritain Health [300] | $120 | 1163% |
| Auto Allstate Insurance [602] | $124 | 1202% |
| Auto American Family Insurance [603] | $124 | 1202% |
| Auto Country Insurance Claims [604] | $124 | 1202% |
| Auto Dairyland Insurance [617] | $124 | 1202% |
| Auto Farmers [605] | $124 | 1202% |
| Auto Geico Claims Oregon [606] | $124 | 1202% |
| Auto Hartford [612] | $124 | 1202% |
| Auto Liberty Mutual Auto Ins [613] | $124 | 1202% |
| Auto Mutual Of Enumclaw [610] | $124 | 1202% |
| Auto Nationwide Allied Insuranc [601] | $124 | 1202% |
| Auto Oregon Mutual [614] | $124 | 1202% |
| Auto Progressive [608] | $124 | 1202% |
| Auto Safeco Concentra [600] | $124 | 1202% |
| Auto State Farm Claims [609] | $124 | 1202% |
| Auto Sublimity Insurance [616] | $124 | 1202% |
| Auto Travelers Insurance [615] | $124 | 1202% |
| Auto Usaa [611] | $124 | 1202% |
| Generic Auto [649] | $124 | 1202% |
| Health Net [340] | $129 | 1250% |
| Administrative Concepts Inc [402] | $135 | 1308% |
| First Health [339] | $135 | 1308% |
| Manhattan Life Insurance Company [379] | $135 | 1308% |
| Philadelphia American Life Insurance Company [395] | $135 | 1308% |
| Planned Administrators Inc [375] | $135 | 1308% |