CMS Price Transparency Data

Culture, blood

Facility: Lee County Community Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $17
  • Cash Discount Price: $18
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Lee County Community Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.65x the Medicare baseline. Located in 127 Health Care Drive, Pennington Gap, VA.
Cash / Self-Pay
$18

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $18 (174%)
Insurance Median: $17 (165%)
Cash: $18 (174% of Medicare)
Ins. Median: $17 (165% 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
Blue Cross Blue Shield $10 - $78 97%
UnitedHealthcare $10 - $17 97%
Aetna $15 - $78 145%
Molina Healthcare $15 - $18 145%
Optima Health $15 145%
Ambetter / Centene $17 165%
Amerigroup $17 - $78 165%
Humana $17 165%
Managed Medicaire $17 165%
Medicare (plans) $17 165%
Mountain Empire Pace $17 165%
Sentara Health $17 - $20 165%
United Mine Workers Of America $17 165%
Cigna $18 - $78 174%
Devoted Health Plan $18 174%
Nhc Advantage $18 174%
Seven Corners, Inc. $41 397%
First Health Coventry $78 756%
Medcost $78 756%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 127 Health Care Drive, Pennington Gap, VA 24277
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals