CMS Price Transparency Data

Culture, blood

Facility: Blount Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $16
Cash Discount Price: $91
vs. Medicare Baseline: 1.55x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Blount Memorial Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.55x the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$16

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: $91 (882%)

Insurance Median: $16 (155%)

Cash: $91 (882% of Medicare)

Ins. Median: $16 (155% 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.

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
Medicaid / KanCare	$4 - $16	39%
Golden Rule Insurance Company [2991]	$6	58%
Oxford Health Plans [2992]	$6	58%
UnitedHealthcare	$6 - $13	58%
Cigna	$8 - $13	78%
Mvp Health Care [3037]	$8	78%
Tricare	$9	87%
Blue Cross Blue Shield	$10 - $53	97%
Humana	$10	97%
Medicare (plans)	$10 - $11	97%
Ambetter / Centene	$16	155%
Consociate Health Contracted [4835]	$23	223%
Fairos/Occunet Contracted [4837]	$24	233%
Prisma Health Seniorcare Pace - Midlands [5400]	$68	659%
Prisma Health Seniorcare Pace-Upstate [5200]	$68	659%
Promise Health Plan Contracted [2401]	$103 - $176	998%
Orangeburg Senior Helping Center Pace [5401]	$118	1143%
Bob Jones Univ-Pai [821]	$176	1705%
Preferred Administrators Contracted [2839]	$206	1996%
Medcost [2940]	$218 - $244	2112%
Atlantic Packaging Contracted [4833]	$220	2132%
Aps Healthcare System [2981]	$235	2277%
Multiplan/Phcs Contracted [2950]	$262	2539%
Aetna	$265	2568%
Meritain Health Contracted [2200]	$265	2568%
Nippon [2300]	$265	2568%
Vsp Vision Care [2986]	$265	2568%
First Health Contracted [2952]	$273	2645%
Furman Int/Allen University Student [2951]	$273	2645%
Quiktrip-First Health [3067]	$273	2645%

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 $91.
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 Blount Memorial 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.