CMS Price Transparency Data

Culture, blood

Facility: Cannon Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $175
  • Cash Discount Price: $146
  • vs. Medicare Baseline: 16.96x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Cannon Memorial Hospital is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 16.96x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.
Cash / Self-Pay
$146

Average discount available for prompt cash payment at this facility.

Insurance Median
$175

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: $146 (1415%)
Insurance Median: $175 (1696%)
Cash: $146 (1415% of Medicare)
Ins. Median: $175 (1696% 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 1696% of the Medicare baseline (a markup of 1596%). 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 $7 68%
Mail Handlers Benefit Plan [327] $7 68%
Rural Carrier Benefit Plan [406] $7 68%
Planned Administrators [886] $12 - $100 116%
Medicaid / KanCare $13 - $292 126%
Other Hospital Payers [1991] $13 - $292 126%
Select Health Of Sc [637] $13 126%
Absolute Total Care [58] $14 136%
Humana $14 - $210 136%
Blue Cross Blue Shield $45 - $277 436%
Blue Choice Health Plan [922] $56 - $108 543%
Employee Benefit Management Services [869] $82 795%
Thomas Cooper & Company [315] $100 969%
Geha [302] $156 1512%
Golden Rule Ins Co [584] $156 1512%
UnitedHealthcare $156 - $292 1512%
Phcs [940] $158 - $193 1531%
Cigna $174 - $292 1686%
Nalc Health Benefit Plan [291] $174 1686%
Medcost [206] $175 - $263 1696%
Preferred Administrators [19] $175 1696%
Coventry Health [245] $182 - $210 1764%
American Continental Ins [778] $292 2829%
American Republic Life Ins [722] $292 2829%
Business Office [6000] $292 2829%
Covid19 Hrsa Uninsured Testing And Treatment Fund [17] $292 2829%
First Health [946] $292 2829%
Guarantee Trust Life Insurance [236] $292 2829%
Home Health Infusion Payer [6001] $292 2829%
Manhattan Life Ins Co [932] $292 2829%
Medicare (plans) $292 2829%
Miscellaneous Commercial [1] $292 2829%
New Era Life Ins Co [437] $292 2829%
Non-Contracted [22] $292 2829%
Physicians Mutual [773] $292 2829%
Reference Based Pricing/Limited Plan [21] $292 2829%
State Farm Ins Co [373] $292 2829%
Sterling Investors Life [244] $292 2829%
Supermed/Med Mutual Of Ohio [539] $292 2829%
United American Ins Co [277] $292 2829%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 123 W G Acker Drive, Pickens, SC 29671
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals