Culture, blood
Facility: Portneuf Medical Center
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $366
- Cash Discount Price: $259
- vs. Medicare Baseline: 35.47x 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 3547% of the Medicare baseline (a markup of 3447%). 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 |
|---|---|---|
| Healthscope Benefits [2290] | $89 | 862% |
| Aetna | $89 - $366 | 862% |
| UnitedHealthcare | $89 - $389 | 862% |
| Moda Health [6100] | $177 | 1715% |
| Lucent Health [6000] | $177 | 1715% |
| Black Lung [6055] | $177 | 1715% |
| Web Tpa [2115] | $177 | 1715% |
| Healthcare Highways [2210] | $177 - $410 | 1715% |
| Employee Benefit Management Services [2445] | $177 - $259 | 1715% |
| Oncology Patient Assistance Programs [2295] | $177 | 1715% |
| Pending Ssi [1616] | $177 | 1715% |
| Pacific Source Health Plans [2850] | $248 | 2403% |
| Liberty Health Share Lhs/Medcost Solutions LLC [2400] | $259 | 2510% |
| Medishare Christian Care [1645] | $259 | 2510% |
| Multiplan [1680] | $289 - $410 | 2800% |
| Worker's Comp [2125] | $314 - $324 | 3043% |
| Cigna | $318 | 3081% |
| Transamerican Life [1990] | $324 | 3140% |
| Enablecomp [1350] | $324 | 3140% |
| First Health [1375] | $356 | 3450% |
| Mailhandlers [1595] | $366 | 3547% |
| Selecthealth [3740] | $366 - $389 | 3547% |
| Humana | $389 | 3769% |
| Geha [1415] | $389 | 3769% |
| UT Id Teamsters [3760] | $410 | 3973% |
| Pba [1775] | $410 | 3973% |
| PHCS [1780] | $410 | 3973% |
| Mayo Clinic Health Solutions [2280] | $410 | 3973% |
| Mutual of Omaha [1685] | $410 | 3973% |
| Planned Administrators Inc [2360] | $410 | 3973% |
| National Association of Letter Carriers [1695] | $410 | 3973% |
| Trustmark [2030] | $410 | 3973% |
| Meritain Health [1655] | $410 | 3973% |
| Hometown Health [2155] | $410 | 3973% |
| Healthfirst [2395] | $410 | 3973% |
| Pan American Life Insurance Co [1770] | $410 | 3973% |
| Healthnet [1495] | $410 | 3973% |
| New Era Life Insurance Company [1705] | $410 | 3973% |
| Administrative Concepts [1005] | $410 | 3973% |