CMS Price Transparency Data

Culture, bacterial

Facility: Monroe County Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $81
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 9.40x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Monroe County Hospital is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 9.40x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

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: $94 (1090%)
Insurance Median: $81 (940%)
Cash: $94 (1090% of Medicare)
Ins. Median: $81 (940% 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 940% of the Medicare baseline (a markup of 840%). 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
Va Ccn - All Plans $9 - $17 104%
Wellmark Hmo $9 104%
Wellmark Ppo - All Other Plans $10 116%
Mahp Mcare - All Plans $45 - $82 522%
Tricare $45 - $82 522%
UnitedHealthcare $45 - $186 522%
Aetna $46 - $184 534%
Amerigroup Mcare $46 - $83 534%
Humana $46 - $83 534%
Wellmark Mcare $46 - $83 534%
Iowa Total Care Mcaid - All Plans $54 - $98 626%
Molina Mcaid - All Plans $55 - $99 638%
Amerigroup Mcaid - All Other Plans $56 - $101 650%
Centivo - All Plans $68 - $123 789%
Midlands Choice - All Plans $76 - $137 882%
Preferred Hlth - All Plans $81 - $147 940%
Geha - All Plans $86 - $157 998%
Multiplan - All Plans $97 - $176 1125%
Integrated Hp - All Plans $105 - $190 1218%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6580 165Th Street, Albia, IA 52531
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals