CMS Price Transparency Data

Culture, blood

Facility: St Jude Childrens Research Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $41
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.97x Medicare

The contracted insurance negotiated median rate for a Culture, blood at St Jude Childrens Research Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 3.97x the Medicare baseline. Located in 262 Danny Thomas Place, Memphis, TN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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%)

Insurance Median: $41 (397%)

Ins. Median: $41 (397% 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 397% of the Medicare baseline (a markup of 297%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$7 - $58	68%
Home State Health	$9	87%
Medicaid / KanCare	$9 - $10	87%
Healthcare Connections La	$10	97%
Healthy Blue	$10	97%
Molina Marketplace Of Ms	$13	126%
Empower	$15	145%
Blue Cross Blue Shield	$22 - $34	213%
Tenncare Select Hmo	$24	233%
Health Choice - Ok	$48	465%
Vantage	$48 - $54	465%
Humana	$52	504%
Aetna	$60	581%
Private Health Care Systems	$64	620%
Ms Physicians Care Network	$68	659%
Baptist Health	$72	698%
Cigna	$72	698%
First Health Ccn	$72	698%
Health Choice	$72	698%
Health Link Mississippi	$72	698%
Healthscope Benefits Inc	$72	698%
Tricare	$80	775%

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 $X.
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 St Jude Childrens Research 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.