CMS Price Transparency Data

Culture, bacterial

Facility: Thomas H Boyd Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $67
Cash Discount Price: $90
vs. Medicare Baseline: 7.77x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Thomas H Boyd Memorial Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 7.77x the Medicare baseline. Located in 800 School St, Carrollton, IL.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $90 (1044%)

Insurance Median: $67 (777%)

Cash: $90 (1044% of Medicare)

Ins. Median: $67 (777% 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 777% of the Medicare baseline (a markup of 677%). 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
Aetna	$8 - $65	93%
Blue Cross Blue Shield	$44 - $96	510%
Meridian Hp Mcaid-All Plans	$44	510%
Molina Mcaid-All Plans	$44	510%
Health Alliance Mcr Adv	$45 - $65	522%
UnitedHealthcare	$45 - $88	522%
Wellcare Mcr Adv-All Plans	$45 - $65	522%
Humana	$46 - $66	534%
Health Alliance-All Other Plans	$54 - $78	626%
Ambetter / Centene	$59 - $85	684%
Cigna	$63 - $91	731%
Multiplan-All Plans	$67 - $96	777%
Healthlink Hmo	$68 - $97	789%
Healthlink Il Only	$68 - $97	789%
Healthlink Ppo-All Other Plans	$77 - $110	893%
Hfn Zelis-All Plans	$81 - $116	940%

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 $90.
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 Thomas H Boyd Memorial Hospital 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.