CMS Price Transparency Data

Culture, blood

Facility: Garfield County Public Hospital District #1

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $113
  • Cash Discount Price: $106
  • vs. Medicare Baseline: 10.95x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Garfield County Public Hospital District #1 is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.95x the Medicare baseline. Located in 66 North Sixth Street, Pomeroy, WA.
Cash / Self-Pay
$106

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $106 (1027%)
Insurance Median: $113 (1095%)
Cash: $106 (1027% of Medicare)
Ins. Median: $113 (1095% 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 1095% of the Medicare baseline (a markup of 995%). 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
Cigna $100 969%
Three Rivers Provider Network - All Plans $106 1027%
Aetna $112 1085%
Coordinated Care - All Plans $112 1085%
First Choice Health Network - All Plans $112 1085%
Premera First - All Plans $112 1085%
Multiplan Primary Network - All Other Plans $115 1114%
Medical Cost Containment Ppo - All Plans $119 1153%
Multiplan Complementary $119 1153%
Provider Network Of America - All Plans $119 1153%
Regence Blue Shield Of Idaho - All Plans $125 1211%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 66 North Sixth Street, Pomeroy, WA 99347
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals