Culture, blood
Facility: Greeley County Health Services
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $9
- Cash Discount Price: $55
- vs. Medicare Baseline: 0.87x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | $9 | 87% |
| Medicaid / KanCare | $9 | 87% |
Consumer Guidance & Cost Commentary
For the CPT code 87040 (Culture, blood) at Greeley County Health Services in Tribune, KS, the cash median price is $55.00, which is significantly lower than the facility's gross charge of $78.00. This service is covered by two payers, Aetna and Medicaid/KanCare, with a negotiated rate of $9.00. While the cash price is the lowest amount listed, patients with high-deductible plans should consider that paying out-of-pocket might be more cost-effective if their insurance negotiated rate exceeds the cash price. It is always recommended to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost.
This facility is a Critical Access Hospital owned by the local government, and its pricing is benchmarked against federal standards. The Medicare amount for this procedure is $10.32, which serves as the objective baseline for evaluating the facility's markup. Although the data does not provide specific Kansas or Greeley County averages for comparison, the facility's cash rate of $55.00 is notably higher than the Medicare rate, illustrating the typical markup found in commercial billing. To ensure you are not overcharged, you should request an itemized billing audit to verify that no unbundled codes or services not rendered are included in your final invoice, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.