CMS Price Transparency Data

Culture, blood

Facility: Mount Desert Island Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $355
Cash Discount Price: $513
vs. Medicare Baseline: 34.40x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Mount Desert Island Hospital is $355. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $513. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 34.40x the Medicare baseline. Located in 10 Wayman Lane, Bar Harbor, ME.

Cash / Self-Pay

$513

Average discount available for prompt cash payment at this facility.

Insurance Median

$355

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: $513 (4971%)

Insurance Median: $355 (3440%)

Cash: $513 (4971% of Medicare)

Ins. Median: $355 (3440% 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 3440% of the Medicare baseline (a markup of 3340%). 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
Martins Point	$244 - $269	2364%
Cigna	$244 - $555	2364%
Wellcare	$244 - $269	2364%
UnitedHealthcare	$244 - $358	2364%
Aetna	$244 - $546	2364%
Blue Cross Blue Shield	$244 - $464	2364%
Healthnet	$352 - $388	3411%
Community Health Options	$461 - $507	4467%
Harvard Pilgrim	$491 - $540	4758%
First Health	$515 - $567	4990%

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 $513.
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 Mount Desert Island 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.