CMS Price Transparency Data

Culture, blood

Facility: Marshfield Medical Center - Weston

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $111
Cash Discount Price: $124
vs. Medicare Baseline: 10.76x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Marshfield Medical Center - Weston is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.76x the Medicare baseline. Located in 3400 Ministry Parkway, Weston, WI.

Cash / Self-Pay

$124

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $124 (1202%)

Insurance Median: $111 (1076%)

Cash: $124 (1202% of Medicare)

Ins. Median: $111 (1076% 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 1076% of the Medicare baseline (a markup of 976%). 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
Security Health Plan (Shp)	$10 - $71	97%
UnitedHealthcare	$10 - $108	97%
Veteran'S Administration (Va Ccn)	$10	97%
Blue Cross Blue Shield	$11 - $64	107%
Group Health Cooperative Of Eau Claire	$11 - $118	107%
Managed Health Services	$12	116%
Family Health Center (Fhc)	$66	640%
Amish/Mennonite	$72	698%
Sanford Health Plan	$72	698%
The Alliance	$74 - $543	717%
Besse Forest Products	$111	1076%
Molina Healthcare Of Wi	$111	1076%
Rice Lake School District	$111	1076%
Wps Health Insurance	$116 - $126	1124%
Medica Of Wi	$122 - $125	1182%
Cigna	$123	1192%
Healtheos By Multiplan Inc.	$123 - $124	1192%
Corvel	$124	1202%
First Health	$124	1202%
Health Partners	$124	1202%
Three Rivers Provider Network (Trpn)	$124	1202%
Trilogy	$125 - $126	1211%
Coventry	$126	1221%
Health Smart	$126	1221%
Rising Medical Work Comp	$127	1231%

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 $124.
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 - Weston 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.