CMS Price Transparency Data

Culture, blood

Facility: Lafollette Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $10
  • Cash Discount Price: $178
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Lafollette Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 0.97x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$178

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $178 (1725%)
Insurance Median: $10 (97%)
Cash: $178 (1725% of Medicare)
Ins. Median: $10 (97% 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
Amerigroup $4 39%
Medicaid / KanCare $5 - $10 48%
UnitedHealthcare $5 - $592 48%
Tricare $9 87%
Aetna $10 - $368 97%
Blue Cross Blue Shield $10 - $103 97%
Humana $10 97%
Medicare (plans) $10 97%
Node Blueadvantage Mcr Adv $10 97%
Node Bluecare Plus Tn Mcr Adv $10 97%
Node Champva $10 97%
Node Devoted Health Mcr Adv $10 97%
Node Farm Bureau Mcr Adv $10 97%
Node Healthspring Mcr Adv $10 97%
Node Hospice Non Par Agree $10 97%
Node Va $10 97%
Node Wellcare Mcr Adv $10 97%
Triwest $10 97%
Veterans Eval Services $10 97%
Wellcare $10 97%
Node Amerigroup Mcr Adv $11 107%
Node Nhc Mcr Adv $11 107%
Windsor Health Plan $11 107%
Node Us Dept Of Labor $13 126%
Novanet Work Comp Tn $15 145%
Tn Work Comp $15 145%
Cigna $16 155%
Ambetter / Centene $19 184%
Bluecare $22 - $25 213%
Node Point Comfort Underwriters $23 223%
Self Pay $170 1647%
Multiplan Complementary $450 4360%
Beech Street Work Comp Tn $1,533 14855%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals