CMS Price Transparency Data

Culture, blood

Facility: Geisinger-Lewistown Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $233
Cash Discount Price: $354
vs. Medicare Baseline: 22.58x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Geisinger-Lewistown Hospital is $233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $354. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 22.58x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$354

Average discount available for prompt cash payment at this facility.

Insurance Median

$233

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: $354 (3430%)

Insurance Median: $233 (2258%)

Cash: $354 (3430% of Medicare)

Ins. Median: $233 (2258% 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 2258% of the Medicare baseline (a markup of 2158%). 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
Advantra	$10	97%
Blue Cross Blue Shield	$10 - $309	97%
Geisinger Health Plan	$10 - $48	97%
Humana	$10	97%
Medicare (plans)	$10	97%
Upmc Health Plan	$10 - $11,890	97%
Medicaid / KanCare	$14	136%
Amerihealth	$15	145%
Geisinger Family Plan	$15	145%
Health Partners	$17	165%
Upmc Chip	$18	174%
Ambetter / Centene	$25	242%
Aetna	$233 - $278	2258%
Cigna	$247 - $300	2393%
UnitedHealthcare	$253	2452%
Christian Healthcare Ministries	$286	2771%
Christian Health Aid	$457	4428%
Three Rivers Provider Network Inc.	$457	4428%
Multiplan	$485	4700%
Healthsmart Payors Organization	$514	4981%

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 $354.
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 Geisinger-Lewistown 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.