CMS Price Transparency Data

Culture, bacterial

Facility: Jefferson County Health Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $40
  • Cash Discount Price: $57
  • vs. Medicare Baseline: 4.64x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Jefferson County Health Center is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 4.64x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$57

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $57 (661%)
Insurance Median: $40 (464%)
Cash: $57 (661% of Medicare)
Ins. Median: $40 (464% 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 464% of the Medicare baseline (a markup of 364%). 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 $8 - $86 93%
Wellmark Hmo $30 348%
Wellmark Indemnity/Ppo - All Other Plans $33 383%
Tricare $37 429%
Amerigroup Mcr Adv $38 441%
Humana $38 441%
Iowa Total Care Comm - All Other Plans $38 441%
Iowa Total Care Mcr $38 441%
Molina Mcr Adv $38 441%
Iowa Total Care Mcaid $40 464%
Molina Mcaid/Chip $40 464%
Medicaid / KanCare $41 476%
Aetna $47 - $86 545%
Medicare (plans) $47 545%
Midlands New Product $78 905%
Coventry Commercial Hmo $81 940%
Coventry Commercial Ppo - All Other Plans $86 998%
Midlands Choice-All Other Plans $86 998%
Molina Marketplace - All Other Plans $95 1102%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals