CMS Price Transparency Data

Culture, blood

Facility: Lewisgale Hospital Pulaski

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $62
  • Cash Discount Price: $393
  • vs. Medicare Baseline: 6.01x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Lewisgale Hospital Pulaski is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $393. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 6.01x the Medicare baseline. Located in 2400 Lee Highway, Pulaski, VA.
Cash / Self-Pay
$393

Average discount available for prompt cash payment at this facility.

Insurance Median
$62

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: $393 (3808%)
Insurance Median: $62 (601%)
Cash: $393 (3808% of Medicare)
Ins. Median: $62 (601% 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 601% of the Medicare baseline (a markup of 501%). 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
Humana $8 - $10 78%
Triatlantic $9 87%
Aetna $10 - $177 97%
Devoted $10 97%
Good Samaritan Hospice $10 97%
Health Net $10 97%
Magellan $10 97%
Sentara Health $10 97%
United $10 - $177 97%
United Mine Workers $10 97%
Align Senior Care $11 107%
Blue Cross Blue Shield $11 - $49 107%
Cigna $11 107%
Clear Spring Health Plan $11 107%
Evernorth Behavioral Health $11 107%
Pyramid Life $11 107%
Virginia Premier Health $11 107%
Lifeworks $75 727%
Universal Healthcare Group $86 833%
Virginia Health Network $138 - $279 1337%
Greenvbrier Sporting Club $236 2287%
Corvel $283 2742%
Richfield Nursing Center $295 2859%
Richfield Retirement Community $295 2859%
Multiplan $303 2936%
Community Care Network $314 3043%
Graham-White Manufacturing $314 3043%
Occunet Workers Comp $314 3043%
One Health Plan $314 3043%
Patients Choice $346 3353%
4Most $354 3430%
American Postal Workers Union $354 3430%
Phcs $354 3430%
Star Transportation $354 3430%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 Lee Highway, Pulaski, VA 24301
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals