CMS Price Transparency Data

Culture, blood

Facility: Lincoln Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $117
Cash Discount Price: $132
vs. Medicare Baseline: 11.34x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Lincoln Hospital is $117. 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 11.34x the Medicare baseline. Located in 10 Nichols Street, Davenport, WA.

Cash / Self-Pay

$132

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $117 (1134%)

Cash: $132 (1279% of Medicare)

Ins. Median: $117 (1134% 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 1134% of the Medicare baseline (a markup of 1034%). 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
Labor & Industries - All Plans	$15	145%
Ambetter / Centene	$69	669%
Molina Hlthy Options	$69	669%
UnitedHealthcare	$69 - $130	669%
Amerigroup Mcaid - All Plans	$73	707%
Aetna	$82 - $140	795%
Indian Hlth Services - All Plans	$82 - $83	795%
Tricare	$82 - $83	795%
Va Ccn - All Plans	$82 - $83	795%
Cigna	$112 - $113	1085%
Focus Healthcare Mgmt - All Plans	$117 - $118	1134%
Molina Exchange-All Other Plans	$117	1134%
Blue Cross Blue Shield	$129 - $130	1250%
Uniform Medical Plan-All Plans	$129 - $130	1250%
First Health Coventry-All Plans	$130 - $131	1260%
Health Management Network-All Plans	$132 - $133	1279%
Three Rivers-All Plans	$132 - $133	1279%
Asuris Nw Health-All Plans	$135 - $136	1308%
Multiplan-All Plans	$139 - $140	1347%
Physician Hosp Comm Org-All Plans	$139 - $140	1347%
First Choice Health- All Plans	$142 - $143	1376%

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 $132.
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 Lincoln 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.