CMS Price Transparency Data

Culture, blood

Facility: Jefferson Healthcare

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $39
Cash Discount Price: $79
vs. Medicare Baseline: 3.78x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Jefferson Healthcare is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 3.78x the Medicare baseline. Located in 834 Sheridan Street, Port Townsend, WA.

Cash / Self-Pay

$79

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $79 (766%)

Insurance Median: $39 (378%)

Cash: $79 (766% of Medicare)

Ins. Median: $39 (378% 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 378% of the Medicare baseline (a markup of 278%). 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
Chpw Mcaid	$8 - $54	78%
Molina Mcaid	$8 - $55	78%
Aetna	$9 - $155	87%
Amerigroup Mcaid-All Plans	$9 - $56	87%
Coord Care Mcaid Ip/Op Only	$9 - $58	87%
Medicare (plans)	$9 - $61	87%
Molina Mcr Adv	$9 - $60	87%
Tricare	$9 - $60	87%
Chpw Mcr Adv	$10 - $65	97%
Molina Marketplace-All Other Plans	$11 - $75	107%
UnitedHealthcare	$15 - $96	145%
Regence-All Other Plans	$20 - $129	194%
Chpw Commercial-All Other Plans	$22 - $146	213%
Premera-All Plans	$22 - $146	213%
Cigna	$23 - $155	223%
Coord Care Cascade Ip/Op Only	$23 - $155	223%
Coord Care Comm/Exchge-All Other Plans	$23 - $155	223%

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 $79.
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 Jefferson Healthcare 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.