Culture, blood
Facility: Mount Sinai Rehabilitation Hospital Inc
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $39
- Cash Discount Price: $39
- vs. Medicare Baseline: 3.78x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 378% of the Medicare baseline (a markup of 278%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $10 | 97% |
| Medicare (plans) | $10 - $11 | 97% |
| Cca Senior Care Options | $10 | 97% |
| Cigna | $10 - $14 | 97% |
| Aetna | $10 - $14 | 97% |
| Blue Cross Blue Shield | $10 - $39 | 97% |
| Geha | $10 | 97% |
| Harvard Pilgrim Healthcare | $10 | 97% |
| Magnacare | $14 | 136% |
| Hap | $14 | 136% |
| Allied Benefit Systems | $14 | 136% |
| Nippon Life Ins | $14 | 136% |
| Luminare Health | $14 | 136% |
| 1199 National Benefit Fund | $14 | 136% |
| Webtpa | $14 | 136% |
| Gravie Admin Services | $14 | 136% |
| Allegiance | $14 | 136% |
| Meritain | $14 | 136% |
| Health Partners | $14 | 136% |
| Diversified Administrators | $22 | 213% |
| Claimdoc | $22 | 213% |
| Innovative Health Plan II | $22 | 213% |
| Connecticut Dept of Correction | $31 | 300% |
| Health New England | $38 | 368% |
| Blue Benefit Administrators of Massachusetts | $39 | 378% |
| Blue Shield - Ny Highmark Western | $39 | 378% |
| Blue Shield - Ny Highmark Northeastern | $39 | 378% |
| Blue Care Network | $39 | 378% |
| Kaiser Domestic | $39 | 378% |
| Pre-Employment | $39 | 378% |
| Health Choices | $39 | 378% |
| Blue Shield - Ca | $39 | 378% |
| Blue Shield - Wa (Regence) | $39 | 378% |
| Wc Domestic | $39 | 378% |
| Blue Shield - Id (Regence) | $39 | 378% |
| Blue Shield - PA (Highmark) | $39 | 378% |
| Unicare | $39 | 378% |
| Blue Distinction Transplant | $39 | 378% |
| Bcn Domestic | $39 | 378% |
| Trinity Health Share | $48 | 465% |
| Paramount HMO | $48 | 465% |
| PHCS | $48 | 465% |
| Dean Health | $48 | 465% |
| Allied National Global Care | $48 | 465% |
| Ghc Scw | $48 | 465% |
| Pai | $48 | 465% |
| Christian Care Ministry | $48 | 465% |
| Medi Share | $48 | 465% |
| Lifetime Benefit Solutions | $48 | 465% |
| Mvp | $48 | 465% |
| Multiplan | $48 | 465% |
| Asrm - Reliance Standard Life Insurance | $48 | 465% |
| Manhattan Life | $48 | 465% |
| Family Life Insurance Company | $48 | 465% |
| Pan-American Life | $48 | 465% |
| International Benefit Administrators | $48 | 465% |
| Prime Health Services | $57 | 552% |
| Connecticare | $58 - $64 | 562% |
| Health Smart | $60 | 581% |