CMS Price Transparency Data

Culture, blood

Facility: Beloit Health System

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $174
Cash Discount Price: $87
vs. Medicare Baseline: 16.86x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Beloit Health System is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 16.86x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$174

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: $87 (843%)

Insurance Median: $174 (1686%)

Cash: $87 (843% of Medicare)

Ins. Median: $174 (1686% 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 1686% of the Medicare baseline (a markup of 1586%). 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
Aetna	$11 - $298	107%
Blue Cross Blue Shield	$11 - $166	107%
Cook Children'S Health Plan (Cchp)	$11 - $157	107%
Dean Health	$11 - $176	107%
Humana	$11 - $40	107%
Independent Care Health Plan	$11	107%
Managed Health Services	$11	107%
Molina Healthcare	$11	107%
Quartz	$11 - $204	107%
UnitedHealthcare	$11 - $236	107%
Wellcare	$11	107%
Naphcare	$16	155%
The Alliance	$42 - $43	407%
Wps	$47 - $233	455%
Wea Trust	$157 - $173	1521%
Multiplan	$229 - $251	2219%
Health Eos	$255 - $286	2471%
Cigna	$263 - $298	2548%
Hfn	$263 - $298	2548%
Preferred Network Access	$263 - $298	2548%

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 $87.
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 Beloit Health System 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.