CMS Price Transparency Data

Culture, bacterial

Facility: Mc Donough District Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $51
  • Cash Discount Price: $37
  • vs. Medicare Baseline: 5.92x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mc Donough District Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 5.92x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
$37

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: $37 (429%)
Insurance Median: $51 (592%)
Cash: $37 (429% 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
Health Alliance $5 - $55 58%
Hfn $8 - $56 93%
Tricare $8 93%
UnitedHealthcare $8 - $56 93%
Aetna $9 - $62 104%
Humana $9 - $56 104%
Medicaid / KanCare $9 - $62 104%
Medicare (plans) $9 104%
Meridian $9 104%
Molina $9 - $62 104%
Mutual Medical $9 - $62 104%
Veteran Affairs $9 104%
Blue Cross Blue Shield $11 - $62 128%
Springfield Health $51 592%
Consociate $53 615%
Trilogy $53 615%
Blue Choice $56 650%
Current Health $56 650%
Healthlink $56 - $58 650%
Preferred Plan $59 684%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals