CMS Price Transparency Data

Culture, blood

Facility: Tristar Northcrest Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $11
  • Cash Discount Price: $224
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Tristar Northcrest Medical Center is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 100 Northcrest Drive, Springfield, TN.
Cash / Self-Pay
$224

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: $224 (2171%)
Insurance Median: $11 (107%)
Cash: $224 (2171% 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
Wellpoint $5 48%
Aetna $8 - $112 78%
Alive Hospice $10 97%
Amerigroup $10 97%
Bright Health $10 - $12 97%
Devoted Health Plan $10 97%
Healthspring $10 97%
Humana $10 - $41 97%
Molina $10 97%
United $10 - $101 97%
Wellcare $10 - $14 97%
Ambetter / Centene $11 107%
American Health Advantage $11 107%
Atrio Golden Times $11 107%
Blue Cross Blue Shield $11 - $14 107%
Evergreen Hmo $11 107%
Zing $11 107%
Novanet $15 145%
Prime Health $15 145%
Cigna $18 - $66 174%
Oscar $31 300%
Nhc Advantage, Inc. $43 417%
City Of Springfield $146 1415%
Multiplan $175 - $184 1696%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Northcrest Drive, Springfield, TN 37172
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals