CMS Price Transparency Data

Culture, blood

Facility: Bellin Health Oconto Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $41
Cash Discount Price: $37
vs. Medicare Baseline: 3.97x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Bellin Health Oconto Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 3.97x the Medicare baseline. Located in 820 Arbutus Ave, Oconto, WI.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $37 (359%)

Insurance Median: $41 (397%)

Cash: $37 (359% of Medicare)

Ins. Median: $41 (397% 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 397% of the Medicare baseline (a markup of 297%). 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
Blue Cross Blue Shield	$19 - $21	184%
Community Care	$19	184%
Humana	$19	184%
My Choice	$19	184%
Network Health	$19 - $48	184%
UnitedHealthcare	$23 - $40	223%
Aetna	$28	271%
Cigna	$40 - $41	388%
Common Ground	$41 - $43	397%
Chorus Community Health Plan	$43	417%
Aspirus Arise	$45	436%
Healthsmart	$46	446%
Ihs(Claimsbridge)	$46	446%
Medical College Of Wi	$46	446%
Hps/Paymedix	$47 - $51	455%
Allied National	$48	465%
First Health	$48	465%
Galaxy Health	$48	465%
Wps Insurance	$48	465%
Three Rivers Provider Network	$51	494%
Trilogy	$51	494%

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 $37.
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 Bellin Health Oconto 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.