Culture, blood
Facility: Ohio Valley Surgical Hospital
Billing Code: 87040 (CPT)
- CPT Billing Code: 87040
- Insurance Median: $11,885
- Cash Discount Price: $86
- vs. Medicare Baseline: 1151.65x 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 115165% of the Medicare baseline (a markup of 115065%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $2 - $40,293 | 19% |
| UnitedHealthcare | $12 - $17,571 | 116% |
| Mhbp | $14 - $20,896 | 136% |
| Personify Health | $14 - $20,896 | 136% |
| Ngs Coresource | $14 - $20,896 | 136% |
| Mail Handlers | $14 - $20,896 | 136% |
| Genworth | $14 - $20,896 | 136% |
| Meritain | $14 - $20,896 | 136% |
| Pacific Source | $14 - $20,896 | 136% |
| Geha | $14 - $20,896 | 136% |
| Aetna | $14 - $20,896 | 136% |
| Nippon Life | $14 - $20,896 | 136% |
| Meritain Heatlh | $14 - $20,896 | 136% |
| Mmoh | $65 - $11,885 | 630% |
| Mmoh (Supermed) | $66 - $67 | 640% |
| Mmo Cin. HMO | $66 - $91 | 640% |
| Medicare (plans) | $86 - $12,264 | 833% |
| Luminare Health | $130 | 1260% |
| Preferred Health | $130 | 1260% |
| Medben | $130 | 1260% |
| Ohio Health | $130 | 1260% |
| Medicaid / KanCare | $3,557 - $17,827 | 34467% |
| Amerihealth Caritas of Ohio | $3,657 | 35436% |
| Buckeye Community Health Plan | $4,022 | 38973% |
| Molina McD | $4,084 | 39574% |
| Caresource | $4,364 - $17,827 | 42287% |
| Humana | $4,493 - $11,919 | 43537% |
| Central States | $11,885 | 115165% |
| Patient No Pay | $11,885 | 115165% |
| Champus | $11,885 | 115165% |
| Medigold | $11,885 | 115165% |
| Molina Marketplace | $11,885 | 115165% |
| Everest | $11,885 | 115165% |
| Aultcare Primetime Health Plan | $11,885 | 115165% |
| Molina | $11,885 | 115165% |
| Bankers Fidelity | $11,885 | 115165% |
| Wellcare By Allwell | $11,885 | 115165% |
| Aarp Supplemental | $11,885 | 115165% |
| Self Pay Imaging | $11,885 | 115165% |
| Molina McR | $11,885 | 115165% |
| Aarp | $11,885 | 115165% |
| Wraparound Pl Supp | $11,885 | 115165% |
| Molina McR+McD | $11,885 | 115165% |
| Cigna | $11,885 - $18,817 | 115165% |
| Prosperity Supplement | $11,885 | 115165% |
| Molina Dual McR | $11,885 | 115165% |
| Communicare Advantage | $11,885 | 115165% |
| American Retirement | $11,885 | 115165% |
| Bankers Life and Casualty | $11,885 | 115165% |
| Molina Dual McR | $11,885 | 115165% |
| American Continental Insurance | $11,885 | 115165% |
| Gateway Health Plan | $11,885 | 115165% |
| American Republic | $11,885 | 115165% |
| Molina McR McD | $11,885 | 115165% |
| American Continental Life | $11,885 | 115165% |
| The Health Plan | $12,479 | 120921% |
| Devoted Health | $13,707 | 132820% |
| Employer Direct | $15,703 | 152161% |
| Shl | $17,571 | 170262% |
| Oxford | $17,571 | 170262% |
| Ushealth | $17,571 | 170262% |
| Surest | $17,571 | 170262% |
| Golden Rule | $17,571 | 170262% |
| Medica | $17,571 | 170262% |
| Caresourse | $17,827 | 172742% |
| Nalc | $18,817 | 182335% |
| Samba | $18,817 | 182335% |
| Healthgram | $18,817 | 182335% |
| Unified Group | $18,817 | 182335% |
| Sbma | $18,817 | 182335% |