CMS Price Transparency Data

Culture, blood

Facility: Physicians Regional Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $12
  • Cash Discount Price: $132
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Physicians Regional Medical Center is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.16x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
$132

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $132 (1279%)
Insurance Median: $12 (116%)
Cash: $132 (1279% of Medicare)
Ins. Median: $12 (116% 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 - $11 39%
Amerigroup Community Care $4 39%
Medicaid / KanCare $5 48%
UnitedHealthcare $5 - $592 48%
Tricare $9 87%
Aetna $10 - $38 97%
Blue Cross Blue Shield $10 - $115 97%
Department Of Veterans Affairs $10 97%
Humana $10 97%
Medicare (plans) $10 97%
Node Bluecare Plus Tn Mcr Adv $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%
Veterans Eval Services $10 97%
Node Nhc Mcr Adv $11 107%
Wellcare $11 107%
Node Us Dept Of Labor $13 126%
Us Department Of Labor $13 126%
Novanet Work Comp Tn $15 145%
Occunet Work Comp Tn $15 145%
Tn Work Comp $15 145%
Cigna $16 155%
Ambetter / Centene $19 184%
Node Point Comfort Underwriters $19 184%
Self Pay $129 - $134 1250%
Multiplan $320 - $421 3101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals