CMS Price Transparency Data

Culture, blood

Facility: Rehabilitation Hospital of Wisconsin

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $101
  • Cash Discount Price: $111
  • vs. Medicare Baseline: 9.79x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Rehabilitation Hospital of Wisconsin is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 9.79x the Medicare baseline. Located in 1625 Coldwater Creek Dr, Waukesha, WI.
Cash / Self-Pay
$111

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $111 (1076%)
Insurance Median: $101 (979%)
Cash: $111 (1076% of Medicare)
Ins. Median: $101 (979% 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 979% of the Medicare baseline (a markup of 879%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Alliance Ppo $50 - $85 484%
Dean Ppo Hmo/Pos $50 - $85 484%
Medica (Under Dean) $50 - $85 484%
UnitedHealthcare $50 - $123 484%
Trilogy Ppo $52 - $123 504%
Wps "Insurance" Ppo $52 - $90 504%
Phcs Savility $54 - $92 523%
Hps Solutions Ppo $55 - $93 533%
Aetna $56 - $123 543%
Health Eos Poc $57 - $98 552%
Coventry/First Health Ppo $59 - $101 572%
Hps (Other) $59 - $101 572%
Health Eos Multiplan $61 - $105 591%
Phcs / Multiplan $66 - $113 640%
All Savers $72 - $123 698%
Blue Cross Blue Shield $72 - $123 698%
Centivo Broad $72 - $123 698%
Centivo Intermediate/Median $72 - $123 698%
Centivo Narrow/Value $72 - $123 698%
Children'S Communty Health Plan(Cchp) $72 - $123 698%
Cigna $72 - $123 698%
Community Care, Inc $72 - $123 698%
Humana $72 - $123 698%
Icare Mcd $72 - $123 698%
Managed Health Services (Mhs) $72 - $123 698%
Medicaid / KanCare $72 - $123 698%
Medicare (plans) $72 - $123 698%
Molina (Fka Care Wisconsin) $72 - $123 698%
Network Health - Aca $72 - $123 698%
Network Health - Commercial $72 - $123 698%
Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) $72 - $123 698%
Security Health Plan - Advocare $72 - $123 698%
Together With Cchp $72 - $123 698%
Unity Health Plan And Unity Quartz(Hmo/Pos) $72 - $123 698%
Va - Primary Only - Authorization Required $72 - $123 698%
Wellcare Mcr $72 - $123 698%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1625 Coldwater Creek Dr, Waukesha, WI 53188
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL