CMS Price Transparency Data

Culture, bacterial

Facility: Wabash General Hospital 1

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $146
Cash Discount Price: $195
vs. Medicare Baseline: 16.94x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Wabash General Hospital 1 is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $195. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 16.94x the Medicare baseline. Located in 1418 College Drive, Mount Carmel, IL.

Cash / Self-Pay

$195

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $195 (2262%)

Insurance Median: $146 (1694%)

Cash: $195 (2262% of Medicare)

Ins. Median: $146 (1694% 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 1694% of the Medicare baseline (a markup of 1594%). 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	$21 - $165	244%
Blue Cross Blue Shield	$21 - $169	244%
Meridian Mcaid - All Plans	$21	244%
Molina Mcaid - All Plans	$21	244%
UnitedHealthcare	$47 - $60	545%
Health Alliance Mcr Adv - All Plans	$62	719%
Healthlink Hmo	$136	1578%
Cigna	$146	1694%
Encore Combined Ip/Op Only	$146	1694%
Hope Trust - All Plans	$146	1694%
Healthlink Ppo - All Other Plans	$156	1810%
Phcs - All Plans	$156	1810%
Health Smart - All Plans	$165	1914%
Hfn - All Plans	$165	1914%
Multiplan - All Plans	$165	1914%
Siho Network - All Plans	$165	1914%
Encore Health Network Ip/Op Only - All Other Plans	$175	2030%

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 $195.
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 Wabash General Hospital 1 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.