CMS Price Transparency Data

Culture, bacterial

Facility: Mercyone Clinton Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $136
  • Cash Discount Price: $311
  • vs. Medicare Baseline: 15.78x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercyone Clinton Medical Center is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $311. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 15.78x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$311

Average discount available for prompt cash payment at this facility.

Insurance Median
$136

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: $311 (3608%)
Insurance Median: $136 (1578%)
Cash: $311 (3608% of Medicare)
Ins. Median: $136 (1578% 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 1578% of the Medicare baseline (a markup of 1478%). 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 - $150 93%
Iowa Total Care $8 - $123 93%
Medicaid / KanCare $8 - $124 93%
Medicare (plans) $8 - $145 93%
Blue Cross Blue Shield $9 - $140 104%
Geha $9 104%
UnitedHealthcare $9 - $172 104%
Amish Hospital Aid $11 - $189 128%
Oscar $12 - $193 139%
Ambetter / Centene $14 - $238 162%
Claimdoc $17 - $285 197%
Nova $17 - $285 197%
Health Choices $49 568%
Medical Associates $49 568%
Preferred Health Choice $50 580%
Iowa Dept Of Public Health $74 - $172 858%
The Alliance $104 1206%
Bcn Domestic $136 1578%
Blue Benefit Administrators Of Massachusetts $136 1578%
Blue Care Network $136 1578%
Blue Distinction Transplant $136 1578%
Blue Shield - Ca $136 1578%
Blue Shield - Id (Regence) $136 1578%
Blue Shield - Ny Highmark Northeastern $136 1578%
Blue Shield - Ny Highmark Western $136 1578%
Blue Shield - Pa (Highmark) $136 1578%
Blue Shield - Wa (Regence) $136 1578%
Kaiser Domestic $136 1578%
Pre-Employment $136 1578%
Wc Domestic $136 1578%
1199 National Benefit Fund $150 1740%
Allied Benefit Systems $150 1740%
Asr Health Benefits $150 1740%
Christian Brother Services $150 1740%
Coventry $150 1740%
First Health $150 1740%
Lucent Health $150 1740%
Luminare Health $150 1740%
Medical Mutual $150 1740%
Meritain $150 1740%
Trustmark Small Business Benefits $150 1740%
Webtpa $150 1740%
Health Partners $151 1752%
Auxiant $155 1798%
Cigna $155 1798%
Medica $155 1798%
Midlands $155 1798%
Midlands Choice $155 1798%
Multiplan $155 1798%
Qualcare $155 1798%
Usa Managed Care $163 1891%
Crime Victim Assistance $172 1995%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals