CMS Price Transparency Data

Culture, bacterial

Facility: Warner Hospital and Health Services

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $104
Cash Discount Price: $191
vs. Medicare Baseline: 12.06x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Warner Hospital and Health Services is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 12.06x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$191

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $191 (2216%)

Insurance Median: $104 (1206%)

Cash: $191 (2216% of Medicare)

Ins. Median: $104 (1206% 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 1206% of the Medicare baseline (a markup of 1106%). 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	$7 - $296	81%
Blue Cross Blue Shield	$7 - $341	81%
Health Alliance Med Adv	$7 - $143	81%
Humana	$7 - $296	81%
Molina Mcr/Mcd Dual	$7 - $143	81%
UnitedHealthcare	$7 - $296	81%
Wellcare Mcr Adv-All Plans	$7 - $143	81%
City Of Clinton (Employees Serv)-All Plans	$14 - $278	162%
Healthlink Hmo	$14 - $271	162%
Caterpillar-All Plans	$15 - $296	174%
Cigna	$15 - $289	174%
Multiplan Phcs-All Plans	$15 - $296	174%
Consociate Care Ppo-All Plans	$16 - $313	186%
Health Alliance-All Other Plans	$16 - $306	186%
Healthlink Ppo/Work Comp-All Other Plans	$16 - $306	186%
Hfn Ppo/Epo-All Plans	$16 - $313	186%
Three Rivers-All Plans	$17 - $330	197%
Harmony Hp Mcaid-All Plans	$32	371%
Medicaid / KanCare	$32	371%
Meridian Hp-All Plans	$32	371%
Molina-All Other Plans	$32	371%

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 $191.
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 Warner Hospital and Health Services 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.