CMS Price Transparency Data

Culture, blood

Facility: Good Samaritan Hospital of Suffern

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $67
  • Cash Discount Price: $165
  • vs. Medicare Baseline: 6.49x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Good Samaritan Hospital of Suffern is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $165. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 6.49x the Medicare baseline. Located in 255 Lafayette Avenue, Suffern, NY.
Cash / Self-Pay
$165

Average discount available for prompt cash payment at this facility.

Insurance Median
$67

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: $165 (1599%)
Insurance Median: $67 (649%)
Cash: $165 (1599% of Medicare)
Ins. Median: $67 (649% 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 649% of the Medicare baseline (a markup of 549%). 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
Mvp Gold (McR) $10 97%
Medicare (plans) $10 - $11 97%
Hamaspik (McR) $10 97%
Affinity By Molina McR $11 107%
Beacon Exchange $12 116%
Beacon Commercial $13 126%
Tricare $13 126%
Aetna $18 - $20 174%
Cigna $22 - $116 213%
Emblem Select Care (Exchange) $26 252%
Emblem Ghi/Hip PPO $30 291%
Geisinger Health Commercial/Exchange $34 329%
Magnacare Preferred $41 397%
Mvp Exchange $45 436%
Self-Pay - Cc 30% $50 484%
Blue Cross Blue Shield $67 - $413 649%
Self-Pay $74 717%
Self-Pay - Cc 50% $82 795%
Oxford Exchange $82 795%
Cdphp $82 795%
Mvp Hmo/Ppo $87 843%
Oxford Commercial $116 1124%
UnitedHealthcare $116 1124%
Magnacare Standard $116 1124%
Multiplan $124 1202%
PHCS $124 1202%
Emblem Ghi/Hip Hmo/Epo/Pos $132 1279%
First Health $140 1357%
Mvp $1,445 - $1,703 14002%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 Lafayette Avenue, Suffern, NY 10901
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals