CMS Price Transparency Data

Culture, blood

Facility: Preston Memorial Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $172
Cash Discount Price: $119
vs. Medicare Baseline: 16.67x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Preston Memorial Hospital is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 16.67x the Medicare baseline. Located in 150 Memorial Drive, Kingwood, WV.

Cash / Self-Pay

$119

Average discount available for prompt cash payment at this facility.

Insurance Median

$172

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: $119 (1153%)

Insurance Median: $172 (1667%)

Cash: $119 (1153% of Medicare)

Ins. Median: $172 (1667% 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 1667% of the Medicare baseline (a markup of 1567%). 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
Unicare	$103	998%
Advantra	$142	1376%
Aetna	$142 - $213	1376%
Humana	$142	1376%
Medicare (plans)	$142 - $192	1376%
Uhc_Va	$142	1376%
Upmc	$149	1444%
Medicaid / KanCare	$154 - $162	1492%
Blue_Cross_Highmark_Aca	$172	1667%
Blue_Cross_Highmark_Pos	$191	1851%
Blue_Cross_Highmark_Ppo	$191	1851%
Blue_Cross_Highmark_Traditional	$210	2035%
UnitedHealthcare	$213	2064%
Cigna	$218	2112%
Geha	$225	2180%
4_Most	$230	2229%
Health	$230	2229%

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 $119.
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 Preston Memorial 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.