CMS Price Transparency Data

Culture, bacterial

Facility: Fayette County Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $95
  • Cash Discount Price: $187
  • vs. Medicare Baseline: 11.02x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Fayette County Hospital is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 11.02x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.
Cash / Self-Pay
$187

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $187 (2169%)
Insurance Median: $95 (1102%)
Cash: $187 (2169% of Medicare)
Ins. Median: $95 (1102% 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 1102% of the Medicare baseline (a markup of 1002%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $17 - $168 197%
Blue Cross Blue Shield $17 - $204 197%
Illinicare - All Plans $17 197%
Medicaid / KanCare $17 197%
Meridian-All Plans $17 197%
Health Alliance Mcare $42 - $78 487%
Healthlink Mcr Adv $42 - $78 487%
Humana $42 - $78 487%
Coventry/Ghp-All Plans $85 - $158 986%
Healthlink Hmo $92 - $170 1067%
Cigna $98 - $182 1137%
Healthlink Ppo - All Other Plans $105 - $194 1218%
Health Alliance - All Other Plans $108 - $201 1253%
UnitedHealthcare $109 - $202 1265%
Multiplan - All Plans $111 - $207 1288%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 650 W Taylor St, Vandalia, IL 62471
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals