CMS Price Transparency Data

Culture, bacterial

Facility: Franklin General Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $49
Cash Discount Price: $104
vs. Medicare Baseline: 5.68x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Franklin General Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 5.68x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$104

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

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: $104 (1206%)

Insurance Median: $49 (568%)

Cash: $104 (1206% of Medicare)

Ins. Median: $49 (568% 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 568% of the Medicare baseline (a markup of 468%). 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
UnitedHealthcare	$10 - $96	116%
Wellmark Hmo	$31	360%
Wellmark Ppo - All Other Plans	$34	394%
Amerigroup Mcare	$46	534%
Medical Associates Mcare	$46	534%
Mount Carmel Hp-All Plans	$46	534%
Tricare	$46	534%
Wellmark Mcr Adv	$46	534%
Ambetter / Centene	$48 - $74	557%
American Hp Iowa - All Plans	$48	557%
Molina Mcare	$48	557%
Amerigroup Mcaid - All Other Plans	$49	568%
Molina Mcaid - All Other Plans	$49	568%
Centivo - All Plans	$69	800%
Medical Ass Hosp Employer Group	$69	800%
Oscar - All Plans	$69	800%
Midlands Choice-All Plans	$80	928%
Medical Associates Hp-All Other Plans	$98	1137%
Preferred Health Choices-All Plans	$98	1137%
Splashlight Llc-All Plans	$98	1137%
Aetna	$107 - $109	1241%
Multiplan-All Plans	$109	1265%

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 $104.
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 Franklin General Hospital 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.