CMS Price Transparency Data
Culture, bacterial
Facility: Mercy Hospital Fort Smith
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $109
- Cash Discount Price: $131
- vs. Medicare Baseline: 12.65x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercy Hospital Fort Smith is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 12.65x the Medicare baseline. Located in 7301 Rogers Ave, Fort Smith, AR.
Cash / Self-Pay
$131
Average discount available for prompt cash payment at this facility.
Insurance Median
$109
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$8.62
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $8.62 (100%)
Cash / Self-Pay: $131 (1520%)
Insurance Median: $109 (1265%)
Cash: $131 (1520% of Medicare)
Ins. Median: $109 (1265% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $8.62 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 1265% of the Medicare baseline (a markup of 1165%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $8 - $12 | 93% |
| American Health Advantage Of Mo Mcr [20264] | $8 | 93% |
| Blue Cross Blue Shield | $8 - $11 | 93% |
| Cherokee Nation Health Serv Contracted [320066] | $8 | 93% |
| Cross Timbers Hospice [20098] | $8 | 93% |
| Dept Of Veteran Affairs Contracted [320106] | $8 | 93% |
| Elara Caring Aspire Hospice Contracted [320433] | $8 | 93% |
| Elara Caring Aspire Hospice [20433] | $8 | 93% |
| Globalhealth Contracted [320145] | $8 | 93% |
| Halo Hcr Inc Hospice Contracted [320432] | $8 | 93% |
| Halo Hcr Inc Hospice [20432] | $8 | 93% |
| Humana | $8 - $197 | 93% |
| Independent Health [20197] | $8 | 93% |
| Jordan Valley Senior Care Pace [20515] | $8 | 93% |
| Kindful Hospice Contracted [320434] | $8 | 93% |
| Kindful Hospice [20434] | $8 | 93% |
| Medicaid / KanCare | $8 - $16 | 93% |
| Medical Associates Health [20444] | $8 | 93% |
| Medicare (plans) | $8 - $9 | 93% |
| Mercy Hospice Okc [20252] | $8 | 93% |
| Pace Of The Ozarks [20518] | $8 | 93% |
| Provider Partners Health Plans Contracted [320450] | $8 | 93% |
| Qual Choice Contracted [320325] | $8 | 93% |
| Spina Bifida Hlthcare Benefit [20506] | $8 | 93% |
| Tribute Health Plan Mcr [20338] | $8 | 93% |
| Tricare | $8 | 93% |
| UnitedHealthcare | $8 - $9 | 93% |
| Valir Pace [20503] | $8 | 93% |
| Wellfirst Health Mcr [20443] | $8 | 93% |
| Cigna | $9 - $22 | 104% |
| United Medical Resources Contracted [320454] | $9 | 104% |
| Health Choice Contracted [320166] | $11 | 128% |
| Usable Contracted [320409] | $11 | 128% |
| Aither Health Contracted [320449] | $12 | 139% |
| Ambetter / Centene | $12 | 139% |
| Arkansas Department Of Health [20036] | $12 | 139% |
| Edison Health Solutions Contracted [320502] | $12 | 139% |
| Home State Health Plan Contracted [320187] | $12 | 139% |
| Mercy Benefit Admin Contracted [320251] | $12 - $148 | 139% |
| Novasys Contracted [320285] | $12 - $21 | 139% |
| Summit Community Care Contracted [320368] | $12 | 139% |
| Summit Community Care [20368] | $12 | 139% |
| Mercy Interfacility [20513] | $13 - $54 | 151% |
| Employers Health Coalition Contracted [320116] | $14 | 162% |
| First Health Contracted [320128] | $26 | 302% |
| Arkansas Total Care Contracted [320039] | $28 | 325% |
| Arkansas Total Care [20039] | $28 | 325% |
| 90 Degree Benefits Contracted [320436] | $30 - $123 | 348% |
| Show-Me Health Administrators Contracted [320483] | $30 - $123 | 348% |
| Auxiant Contracted [320462] | $35 - $160 | 406% |
| Ebms Contracted [320493] | $35 - $148 | 406% |
| Healthlink Contracted [320179] | $35 - $160 | 406% |
| Imagine 360 Contracted [320494] | $35 - $148 | 406% |
| Municipal Health Plan Contracted [320271] | $35 - $148 | 406% |
| Reflect Health Contracted [320492] | $35 - $148 | 406% |
| Insurance System Inc Contracted [320465] | $38 - $160 | 441% |
| Personify Health Contracted [320051] | $38 - $160 | 441% |
| Preferred Health Plan Contracted [320522] | $38 - $160 | 441% |
| Qual Choice Contracted [320324] | $38 | 441% |
| Workers Comp [20426] | $38 - $160 | 441% |
| Ppo Plus Contracted [320310] | $44 - $184 | 510% |
| Private Health Care Systems Contracted [320320] | $47 - $197 | 545% |
| Private Health Care Systems [20320] | $47 - $197 | 545% |
| Multiplan Contracted [320270] | $50 - $209 | 580% |
| Multiplan [20270] | $50 - $209 | 580% |