CMS Price Transparency Data

Culture, bacterial

Facility: Decatur County Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $51
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 5.92x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Decatur County Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 5.92x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

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: $46 (534%)
Insurance Median: $51 (592%)
Cash: $46 (534% of Medicare)
Ins. Median: $51 (592% 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 592% of the Medicare baseline (a markup of 492%). 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
UnitedHealthcare $5 - $186 58%
Blue Cross Blue Shield $17 - $70 197%
Champva -All Plans $24 - $99 278%
Everystep Hospice-All Plans $28 - $114 325%
Aetna $29 - $173 336%
Tricare $29 - $118 336%
Wellmark Hmo $31 360%
Wellmark Ppo - All Other Plans $34 394%
Benefit Admin System-All Plans $35 - $142 406%
Humana $39 - $160 452%
Meritain Health-All Plans $39 - $160 452%
Misc Commercial-All Plans $39 - $160 452%
All Savers-All Plans $40 - $164 464%
Allied Benefit System-All Plans $40 - $164 464%
American Family Ins Grp-All Plans $40 - $164 464%
Rural Carrier Benefit Plan-All Plans $42 - $169 487%
Christian Healthcare -All Plans $43 - $175 499%
Medica-All Other Plans $43 - $175 499%
Cigna $46 - $188 534%
Golden Rule-All Plans $46 - $186 534%
Ntca The Rural Broadband-All Plans $46 - $186 534%
Medical Mutual-All Plans $48 - $193 557%
Farm Bureau Financial-All Other Plans $49 - $197 568%
Farm Bureau Property And Ca $49 - $197 568%
Medi Share-All Plans $49 - $199 568%
Uhss-All Plans $49 - $199 568%
Health Partners-All Plans $50 - $201 580%
Lewermark-All Plans $51 - $208 592%
Mail Handlers Benefit-All Plans $53 - $215 615%
Midlands Choice-All Plans $53 - $215 615%
Priority Health-All Plans $54 - $219 626%
Iowa Total Care Mcaid-All Plans $55 - $223 638%
Amerigroup Mcaid-All Plans $57 - $230 661%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals