CMS Price Transparency Data

Culture, blood

Facility: Gateway Rehabilitation Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $108
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 10.47x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Gateway Rehabilitation Hospital is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 10.47x the Medicare baseline. Located in 5940 Merchants St, Florence, KY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$108

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%)
Insurance Median: $108 (1047%)
Ins. Median: $108 (1047% 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 1047% of the Medicare baseline (a markup of 947%). 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.

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
Aetna $6 - $108 58%
Wellcare $108 1047%
Kentucky $108 1047%
Cigna $108 1047%
UnitedHealthcare $108 1047%
Molina $108 1047%
Caresource Ohio $108 1047%
Devoted Health Plan $108 1047%
Humana $108 1047%
Caresource Kentucky $108 1047%
Blue Cross Blue Shield $108 1047%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5940 Merchants St, Florence, KY 41042
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL