CMS Price Transparency Data

Culture, bacterial

Facility: University of Iowa Hospital & Clinics

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $91
Cash Discount Price: $127
vs. Medicare Baseline: 10.56x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at University of Iowa Hospital & Clinics is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 10.56x the Medicare baseline. Located in 200 Hawkins Drive, Iowa City, IA.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $127 (1473%)

Insurance Median: $91 (1056%)

Cash: $127 (1473% of Medicare)

Ins. Median: $91 (1056% 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 1056% of the Medicare baseline (a markup of 956%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Iowa Total Care	$8 - $9	93%
Molina Healthcare	$8 - $9	93%
Wellpoint (Amerigroup)	$8 - $9	93%
Aetna	$9 - $139	104%
American Health Plan	$9	104%
Blue Cross Blue Shield	$9 - $87	104%
Healthpartners	$9 - $154	104%
Medical Associates	$9 - $90	104%
UnitedHealthcare	$9 - $77	104%
Aplos Health Plan	$19 - $145	220%
Quad City Community Healthcare	$19 - $136	220%
Immergrun	$30 - $45	348%
Midlands Choice	$34 - $118	394%
Oscar Health	$76 - $114	882%
Great River Health Systems	$85 - $127	986%
Progyny	$91 - $136	1056%
Sedgwick	$97 - $145	1125%
Global Excel	$103 - $154	1195%
Sanford Health Plan	$103 - $154	1195%
Employee Benefit Systems	$106 - $163	1230%
Sisco	$106 - $159	1230%
Healthsmart	$109 - $163	1265%
Hfn	$111 - $167	1288%
Multiplan	$111 - $167	1288%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $127.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87070.

Insurance In-Network Protection Plan

Contact your insurance company to confirm University of Iowa Hospital & Clinics is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87070.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.