CMS Price Transparency Data

Culture, bacterial

Facility: Mercyone Clinton Medical Center

Billing Code: 87070 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$26

about 2.9× the $9 Medicare rate · typically $9–$118

modeled estimate · not a bill or quote

Medicare pays $9 Fair price $26 Hospital's list price $172

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$9 - $172	104%
Blue Cross Blue Shieldmajor	$9 - $140	104%
Aetnamajor	$8 - $150	93%
Cignamajor	$155	1798%
Kaiser Permanentemajor	$136	1578%
Ambetter (Centene)	$14 - $238	162%
GEHA	$9	104%
HealthPartners	$151	1752%
Medica	$155	1798%
Medical Mutual	$150	1740%
Oscar Health	$12 - $193	139%
+ 24 smaller / regional plans	$8 - $285

Government programs also on file: Medicare, Medicaid.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 87070.

Insurance Before you use insurance

Call your insurance company to confirm Mercyone Clinton Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 87070.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Other Procedures at Mercyone Clinton Medical Center

Compare: Culture, bacterial at other IA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.