Culture, blood
Facility: Hackensack Meridian Mountainside Medical
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $177
- Cash Discount Price: $12
- vs. Medicare Baseline: 17.15x 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 1715% of the Medicare baseline (a markup of 1615%). 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 | $22 | 213% |
| Healthscope Benefits [2290] | $22 - $177 | 213% |
| Aetna | $32 | 310% |
| Wtc Healthcare Sme Karna [8005] | $85 | 824% |
| Black Lung [6055] | $85 | 824% |
| Worker's Comp [2125] | $85 - $193 | 824% |
| Medicare (plans) | $85 | 824% |
| Oncology Patient Assistance Programs [2295] | $85 | 824% |
| Lucent Health [6000] | $85 | 824% |
| Web Tpa [2115] | $85 | 824% |
| Selecthealth [3740] | $85 | 824% |
| Create Flex / Select [3580] | $85 | 824% |
| Healthcare Highways [2210] | $85 - $177 | 824% |
| First Health [1375] | $156 - $177 | 1512% |
| Cigna | $166 | 1609% |
| Mayo Clinic Health Solutions [2280] | $177 | 1715% |
| Planned Administrators Inc [2360] | $177 | 1715% |
| Mutual of Omaha [1685] | $177 | 1715% |
| Pan American Life Insurance Co [1770] | $177 | 1715% |
| Universal Fidelity [2085] | $177 | 1715% |
| PHCS [1780] | $177 | 1715% |
| Healthcost Solutions [2415] | $177 | 1715% |
| Gilsbar [1425] | $177 | 1715% |
| Resource One Administrators [2815] | $177 | 1715% |
| Healthnet [1495] | $177 | 1715% |
| Pba [1775] | $177 | 1715% |
| Hometown Health [2155] | $177 | 1715% |
| Trustmark [2030] | $177 | 1715% |
| Multiplan [1680] | $177 | 1715% |
| Allied National Global Care [1035] | $177 | 1715% |
| New Era Life Insurance Company [1705] | $177 | 1715% |
| Healthfirst [2395] | $177 | 1715% |
| Administrative Concepts [1005] | $177 | 1715% |
| Humana | $193 | 1870% |
| Emblem Health [2430] | $193 | 1870% |
| Blue Cross Blue Shield | $205 | 1986% |
| Mva [1690] | $208 | 2016% |
| Amerihealth [3520] | $208 | 2016% |