CMS Price Transparency Data

Culture, blood

Facility: St Francis Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $444
Cash Discount Price: $399
vs. Medicare Baseline: 43.02x Medicare

The contracted insurance negotiated median rate for a Culture, blood at St Francis Hospital is $444. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $399. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 43.02x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$399

Average discount available for prompt cash payment at this facility.

Insurance Median

$444

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: $399 (3866%)

Insurance Median: $444 (4302%)

Cash: $399 (3866% of Medicare)

Ins. Median: $444 (4302% 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 4302% of the Medicare baseline (a markup of 4202%). 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
Molina Healthcare	$11 - $122	107%
Wexford	$11	107%
Meridian Health Plan	$12	116%
Clear Spring Health of Illinois	$116	1124%
Humana	$116	1124%
Blue Cross Blue Shield	$116 - $127	1124%
UnitedHealthcare	$122 - $554	1182%
Aetna	$122 - $389	1182%
Amish Community	$155	1502%
Celtic Insurance Company	$280	2713%
Claim Doc	$291	2820%
Hopetrust	$319	3091%
Wellfirst	$356	3450%
First Health	$411	3983%
Cigna	$443	4293%
Caterpillar, Inc.	$444	4302%
Current Health Solutions	$465	4506%
Consociate Group	$471	4564%
Multiplan/Phcs	$471	4564%
Healthlink	$473	4583%
Provider Network of America	$499	4835%
Healthcare Finest Network (Hfn)	$499	4835%
Naphcare	$554	5368%
Live360	$554	5368%
Illinois Breast and Cervical Cancer Program	$554	5368%
Healthscope	$554	5368%
Health Alliance Medical Plans	$554	5368%
Interplan	$554	5368%

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 $399.
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 St Francis 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.