CMS Price Transparency Data

Culture, bacterial

Facility: Mercyone Des Moines Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $110
  • Cash Discount Price: $205
  • vs. Medicare Baseline: 12.76x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercyone Des Moines Medical Center is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 12.76x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$205

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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: $205 (2378%)
Insurance Median: $110 (1276%)
Cash: $205 (2378% of Medicare)
Ins. Median: $110 (1276% 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 1276% of the Medicare baseline (a markup of 1176%). 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 - $110 93%
Iowa Total Care $8 - $2,508 93%
Medicaid / KanCare $8 - $2,542 93%
Medicare (plans) $8 - $46 93%
Blue Cross Blue Shield $9 - $217 104%
Geha $9 - $4,658 104%
UnitedHealthcare $9 - $4,662 104%
Amish Hospital Aid $11 - $60 128%
Centivo $12 - $65 139%
Oscar $12 - $64 139%
Ambetter / Centene $14 - $76 162%
Claimdoc $17 - $91 197%
Nova $17 - $91 197%
Health Choices $60 - $64 696%
Medical Associates $60 - $64 696%
Iowa Dept Of Public Health $74 - $317 858%
1199 National Benefit Fund $103 - $110 1195%
Allied Benefit Systems $103 - $110 1195%
Asr Health Benefits $103 - $110 1195%
Christian Brother Services $103 - $110 1195%
Coventry $103 - $110 1195%
First Health $103 - $110 1195%
Lucent Health $103 - $110 1195%
Luminare Health $103 - $110 1195%
Medical Mutual $103 - $110 1195%
Meritain $103 - $110 1195%
Trustmark Small Business Benefits $103 - $110 1195%
Webtpa $103 - $110 1195%
Cigna $179 - $190 2077%
Health Partners $189 - $201 2193%
Auxiant $194 - $206 2251%
Medica $194 - $206 2251%
Midlands $194 - $206 2251%
Midlands Choice $194 - $206 2251%
Blue Benefit Administrators Of Massachusetts $217 2517%
Blue Care Network $217 2517%
Blue Distinction Transplant $217 2517%
Blue Shield - Ca $217 2517%
Blue Shield - Id (Regence) $217 2517%
Blue Shield - Ny Highmark Northeastern $217 2517%
Blue Shield - Ny Highmark Western $217 2517%
Blue Shield - Pa (Highmark) $217 2517%
Blue Shield - Wa (Regence) $217 2517%
Usa Managed Care $253 - $269 2935%
Crime Victim Assistance $298 - $317 3457%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 6Th Ave, Des Moines, IA 50314
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals