CMS Price Transparency Data

Culture, bacterial

Facility: Mercyone Elkader Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $107
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 12.41x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercyone Elkader Medical Center is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 12.41x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$95

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $95 (1102%)
Insurance Median: $107 (1241%)
Cash: $95 (1102% of Medicare)
Ins. Median: $107 (1241% 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 1241% of the Medicare baseline (a markup of 1141%). 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
Blue Cross Blue Shield $75 870%
Aetna $76 - $107 882%
Medicare (plans) $77 - $79 893%
UnitedHealthcare $80 - $110 928%
Iowa Total Care $91 1056%
Medicaid / KanCare $92 - $93 1067%
Amish Hospital Aid $101 1172%
1199 National Benefit Fund $107 1241%
Allied Benefit Systems $107 1241%
Asr Health Benefits $107 1241%
Christian Brother Services $107 1241%
Coventry $107 1241%
First Health $107 1241%
Lucent Health $107 1241%
Luminare Health $107 1241%
Medical Mutual $107 1241%
Meritain $107 1241%
Trustmark Small Business Benefits $107 1241%
Webtpa $107 1241%
Geha $110 1276%
Centivo $114 1323%
Health Choices $117 1357%
Medical Associates $117 1357%
Ambetter / Centene $128 1485%
Health Partners $140 1624%
Auxiant $143 1659%
Cigna $143 1659%
Medica $143 1659%
Midlands $143 1659%
Midlands Choice $143 1659%
Crime Victim Assistance $146 1694%
Iowa Dept Of Public Health $146 1694%
Claimdoc $153 1775%
Nova $153 1775%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals