CMS Price Transparency Data

Culture, blood

Facility: Jefferson Abington Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $11
  • Cash Discount Price: $12
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Jefferson Abington Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 1200 Old York Road, Abington, PA.
Cash / Self-Pay
$12

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: $12 (116%)
Insurance Median: $11 (107%)
Cash: $12 (116% 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
Pro United Commercial $6 58%
Abington Pro Ibc $7 68%
Blue Cross Blue Shield $7 - $10 68%
Medicare (plans) $7 - $15 68%
Aetna $10 - $27 97%
Innovage $10 97%
Innovage Pro $10 97%
Inspira Life $10 97%
Inspira Life Pro $10 97%
Jefferson Health Plan Aca Exchange $10 97%
Jefferson Health Plan Aca Qhp Exchange $10 97%
Jup Highmark $10 97%
Point Of Comfort Refugee Resettlement $10 97%
Provider Partners Health Plan $10 97%
Tricare $10 97%
UnitedHealthcare $10 - $15 97%
Abington Pro Keystone First Vip $11 107%
Allwell Pa Health_Wellness Ma $11 107%
Cigna $11 - $15 107%
Devoted Health Participation $11 107%
Humana $11 107%
Keystone First Vip Choice $11 107%
Pro Provider Partners Pphp $11 107%
Highmark Wholecare Gateway $12 116%
Highmark Wholecare Gateway Pro $12 116%
Perennial $12 116%
Perennial Pro $12 116%
Ibc Employee Benefit $13 126%
Ibc Main Line Health $13 126%
Ibc $14 - $34 136%
Ambetter / Centene $15 145%
Medicaid / KanCare $15 - $28 145%
Pro Naphcare $15 145%
Upmc Commercial $15 145%
Jup Health Partners Chip $16 155%
Keystone First $17 165%
Naphcare $17 165%
Pa Health_Wellness Chc $18 174%
Highmark $25 - $29 242%
Jup Geisinger Commercial $26 252%
Geisinger Health Plan $42 407%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Old York Road, Abington, PA 19001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals