CMS Price Transparency Data

Culture, blood

Facility: Saint Vincent Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $11
  • Cash Discount Price: $76
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Saint Vincent Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 232 West 25Th Street, Erie, PA.
Cash / Self-Pay
$76

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $76 (736%)
Insurance Median: $11 (107%)
Cash: $76 (736% of Medicare)
Ins. Median: $11 (107% 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.

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
Highmark $5 - $16 48%
Cigna $8 - $11 78%
Univera $9 - $12 87%
American Health Plans $10 97%
Life Pittsburgh $10 97%
Martin'S Point $10 97%
UnitedHealthcare $10 - $22 97%
University Of Pittsburgh Medical Center $10 - $43 97%
Aetna $11 - $21 107%
Amerihealth $11 - $14 107%
Blue Cross Blue Shield $11 - $16 107%
Highmark Wholecare $11 - $19 107%
Humana $11 107%
Medical Mutual $11 107%
Medicare (plans) $11 107%
Molina $11 107%
Jefferson Health Plans $14 - $21 136%
Pennsylvania Health And Wellness $21 203%
Geisinger $22 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 232 West 25Th Street, Erie, PA 16544
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals