CMS Price Transparency Data

Culture, bacterial

Facility: Memorial Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $181
Cash Discount Price: $301
vs. Medicare Baseline: 21.00x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Memorial Medical Center is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $301. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 21.00x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$301

Average discount available for prompt cash payment at this facility.

Insurance Median

$181

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: $301 (3492%)

Insurance Median: $181 (2100%)

Cash: $301 (3492% of Medicare)

Ins. Median: $181 (2100% 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 2100% of the Medicare baseline (a markup of 2000%). 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
Health Alliance	$4 - $196	46%
Veterans Administration	$6	70%
Aetna	$8 - $229	93%
Blue Cross Blue Shield	$8 - $301	93%
Medicare (plans)	$8 - $301	93%
Tricare	$8	93%
UnitedHealthcare	$8 - $187	93%
Humana	$9 - $181	104%
Medicaid / KanCare	$11	128%
Molina	$11	128%
Healthlink	$30 - $190	348%
Commercial Workers Compensation	$108	1253%
Illinois Workers Compensation	$113	1311%
Current Health Network Ppo	$135	1566%
Cigna	$158	1833%
Phcs/Multiplan	$163 - $181	1891%
6 Degrees Health	$181	2100%
Hopetrust	$181	2100%
Hst	$181	2100%
Magellan	$181	2100%
Consociate	$196	2274%
Hfn	$196	2274%
Preferred Plan	$226	2622%
Soi Mcfarland	$226	2622%
Soi Rushville	$226	2622%
Corvel	$241	2796%
Methodist First Choice	$241	2796%
Mutual Medical Plans	$256	2970%
Liability	$301	3492%

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 $301.
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 Memorial Medical 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.