CMS Price Transparency Data

Culture, bacterial

Facility: Kossuth Regional Health Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $73
Cash Discount Price: $107
vs. Medicare Baseline: 8.47x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Kossuth Regional Health Center is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 8.47x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.

Cash / Self-Pay

$107

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $107 (1241%)

Insurance Median: $73 (847%)

Cash: $107 (1241% of Medicare)

Ins. Median: $73 (847% 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 847% of the Medicare baseline (a markup of 747%). 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
Blue Cross Blue Shield	$9 - $10	104%
Mercy One - All Plans	$28 - $60	325%
Va Ccn - All Plans	$28 - $60	325%
Amerigroup Mcr Adv - All Other Plans	$29 - $62	336%
Humana	$29 - $61	336%
UnitedHealthcare	$29 - $121	336%
Health Partners New Bus - All Other Plans	$52 - $111	603%
Midlands Choice - All Plans	$52 - $111	603%
Medical Associates - All Plans	$64 - $135	742%
Preferred Health - All Plans	$64 - $135	742%
Aetna	$70 - $154	812%
Multiplan - All Plans	$71 - $151	824%
Health Partners Exisiting Bus	$73 - $154	847%
Molina Mcaid/Chip - All Plans	$77 - $163	893%
Amerigroup Mcaid	$78 - $165	905%

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 $107.
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 Kossuth Regional Health 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.