CMS Price Transparency Data

Culture, bacterial

Facility: Mercyone Oelwein Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $80
Cash Discount Price: $237
vs. Medicare Baseline: 9.28x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Mercyone Oelwein Medical Center is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $237. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 9.28x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.

Cash / Self-Pay

$237

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $237 (2749%)

Insurance Median: $80 (928%)

Cash: $237 (2749% of Medicare)

Ins. Median: $80 (928% 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 928% of the Medicare baseline (a markup of 828%). 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
Medicare (plans)	$8 - $62	93%
Aetna	$9	104%
Blue Cross Blue Shield	$9 - $59	104%
UnitedHealthcare	$9 - $104	104%
Iowa Total Care	$57	661%
Medicaid / KanCare	$57 - $58	661%
Amish Hospital Aid	$80	928%
Centivo	$90	1044%
Ambetter / Centene	$101	1172%
Geha	$104	1206%
Health Choices	$107	1241%
Medical Associates	$107	1241%
Claimdoc	$120	1392%
Nova	$120	1392%
Health Partners	$140	1624%
Multiplan	$142	1647%
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%

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 $237.
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 Mercyone Oelwein Medical Center 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.