CMS Price Transparency Data

Culture, bacterial

Facility: Anderson Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $13
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Anderson Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.51x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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: $86 (998%)
Insurance Median: $13 (151%)
Cash: $86 (998% of Medicare)
Ins. Median: $13 (151% 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.

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
Medicaid / KanCare $6 - $11 70%
Aetna $8 - $13 93%
Humana $8 93%
Medicare (plans) $8 - $9 93%
Tricare $8 93%
UnitedHealthcare $8 - $14 93%
Clear Springs Health $9 104%
Devoted Health Ppo $9 104%
Essence $9 104%
Health Care Service Corporation $10 - $79 116%
Ambetter / Centene $12 139%
Blue Choice $12 139%
Mercy Benefit Admin $14 162%
Mercy Aco $15 174%
Hopetrust $22 255%
Work Comp $42 - $26,600 487%
Healthlink $47 545%
Self Pay $86 - $25,000 998%
Blue Cross Blue Shield $93 - $96 1079%
Cigna $129 1497%
Multiplan/Phcs $129 1497%
Beech Street Corporation $155 1798%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 State Route 162, Maryville, IL 62062
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals