CMS Price Transparency Data

Culture, blood

Facility: Sisters of Charity Hospital

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $11
  • Cash Discount Price: $8
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Sisters of Charity Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 1.07x the Medicare baseline. Located in 2157 Main Street, Buffalo, NY.
Cash / Self-Pay
$8

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $8 (78%)
Insurance Median: $11 (107%)
Cash: $8 (78% of Medicare)
Ins. Median: $11 (107% 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.

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
Beacon Essential [350122] $8 78%
Crime Victims [100176] $8 78%
Medicaid / KanCare $8 - $10 78%
Excellus Rochester McD [350117] $8 78%
Independent Health [100165] $8 - $11 78%
Iha First Choice [800001] $8 78%
Tuscarora Nation [550120] $8 78%
UnitedHealthcare $8 - $11 78%
Univera Healthcare Essential [100170] $8 - $10 78%
Independent Health Essential [100166] $9 87%
Seneca Nation [450119] $10 97%
Federal Workers Compensation [500100] $10 97%
Covid19 Hrsa [45013] $10 97%
VA Veterans Affairs [700001] $10 97%
Hospice [550001] $10 97%
Tricare $10 97%
Cigna $10 97%
Blue Cross Blue Shield $10 - $20 97%
Fallon Health [450115] $10 97%
Champ VA [700002] $10 97%
Medicare (plans) $10 - $11 97%
Catholic Health Life Pace [400005] $10 97%
Univera Healthcare [100169] $11 - $15 107%
Fidelis Dual Advantage [450120] $11 107%
Aetna $11 107%
Wellcare [450129] $11 107%
Wellcare Fidelis Dual [450451] $11 107%
Humana $11 107%
Fidelis Exchange [100164] $15 145%
No Fault [114001] $18 174%
Workers Compensation [500101] $18 174%
Fidelis Essential [100163] $19 184%
Molina Essential [100167] $19 184%
Amerigroup [350102] $20 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2157 Main Street, Buffalo, NY 14214
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals