CMS Price Transparency Data

Culture, bacterial

Facility: Mercyone Waterloo Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $23
  • Cash Discount Price: $72
  • vs. Medicare Baseline: 2.67x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercyone Waterloo Medical Center is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 2.67x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.
Cash / Self-Pay
$72

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $72 (835%)
Insurance Median: $23 (267%)
Cash: $72 (835% of Medicare)
Ins. Median: $23 (267% 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 267% of the Medicare baseline (a markup of 167%). 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
Aetna $8 - $23 93%
Iowa Total Care $8 93%
Medicaid / KanCare $8 93%
Medicare (plans) $8 - $9 93%
Blue Cross Blue Shield $9 104%
Geha $9 104%
UnitedHealthcare $9 - $110 104%
Amish Hospital Aid $11 128%
Oscar $13 151%
Ambetter / Centene $14 162%
Centivo $14 162%
Claimdoc $17 197%
Nova $17 197%
Health Choices $22 - $26 255%
Medical Associates $22 - $26 255%
Allied Benefit Systems $23 267%
Asr Health Benefits $23 267%
Christian Brother Services $23 267%
Coventry $23 267%
First Health $23 267%
Lucent Health $23 267%
Luminare Health $23 267%
Medical Mutual $23 267%
Meritain $23 267%
Webtpa $23 267%
Health Partners $61 - $72 708%
Auxiant $66 - $78 766%
Cigna $66 - $78 766%
Medica $66 - $78 766%
Midlands $66 - $78 766%
Midlands Choice $66 - $78 766%
Iowa Dept Of Public Health $93 - $110 1079%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3421 West Ninth Street, Waterloo, IA 50702
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals