CMS Price Transparency Data

Culture, blood

Facility: University Health System, Inc

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $80
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 7.75x Medicare
The contracted insurance negotiated median rate for a Culture, blood at University Health System, Inc is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 7.75x the Medicare baseline. Located in 1924 Alcoa Highway, Knoxville, TN.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$80

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: $50 (484%)
Insurance Median: $80 (775%)
Cash: $50 (484% of Medicare)
Ins. Median: $80 (775% 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 775% of the Medicare baseline (a markup of 675%). 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
UnitedHealthcare $4 - $140 39%
Cigna $10 - $152 97%
Humana $10 97%
Aetna $11 - $140 107%
American Health $11 107%
Blue Cross Blue Shield $11 - $128 107%
Devoted Health $11 107%
Medicare (plans) $11 107%
Nhc $11 107%
Wellcare-Windsor Medadv $11 107%
Wellpoint $11 - $13 107%
Fentress County Sheriffs Dept $80 775%
Multiplan $120 1163%
Nx Health $120 1163%
Phcs $120 1163%
Naphcare $130 1260%
Coventry $140 1357%
Beechstreet $150 1453%
Prime Health $150 - $200 1453%
Seven Corners $150 1453%
Usa $160 1550%
Evolutions $180 1744%
Galaxy $180 1744%
Healthsmart $180 1744%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1924 Alcoa Highway, Knoxville, TN 37920
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals