CMS Price Transparency Data

Culture, blood

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $109
Cash Discount Price: $180
vs. Medicare Baseline: 10.56x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $180. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.56x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$180

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $180 (1744%)

Insurance Median: $109 (1056%)

Cash: $180 (1744% of Medicare)

Ins. Median: $109 (1056% 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 1056% of the Medicare baseline (a markup of 956%). 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
Humana	$10 - $168	97%
Managed Health Services	$10 - $11	97%
Molina Healthcare Of Wi	$10 - $161	97%
Network Health Plan	$10 - $158	97%
Quartz	$10 - $108	97%
Security Health Plan (Shp)	$10 - $109	97%
UnitedHealthcare	$10 - $36	97%
Veteran'S Administration (Va Ccn)	$10	97%
Blue Cross Blue Shield	$11 - $54	107%
Group Health Cooperative Of Eau Claire	$11 - $180	107%
Icare	$11 - $12	107%
My Choice	$11	107%
Trilogy	$11 - $170	107%
The Alliance	$96	930%
Amish/Mennonite	$104	1008%
Wps Health Insurance	$127	1231%
Cigna	$129 - $140	1250%
Health Payment Systems	$132	1279%
First Health	$161	1560%
Healtheos By Multiplan Inc.	$176 - $180	1705%
Health Partners	$180	1744%
Coventry	$181	1754%

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 $180.
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 Marshfield Medical Center - Beaver Dam (Mmc-Bd) 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.