CMS Price Transparency Data

Culture, bacterial

Facility: Ascension St Vincent Randolph

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $6
Cash Discount Price: $160
vs. Medicare Baseline: 0.70x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Ascension St Vincent Randolph is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 0.70x the Medicare baseline. Located in 473 E Greenville Ave, Winchester, IN.

Cash / Self-Pay

$160

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $160 (1856%)

Insurance Median: $6 (70%)

Cash: $160 (1856% of Medicare)

Ins. Median: $6 (70% 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.

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
Smarthealth Ppo	$3 - $9	35%
Smarthealth Ppo/Hdhp 20161001	$3 - $9	35%
Blue Cross Blue Shield	$4 - $11	46%
Encore Exclusive	$4	46%
Patoka Valley Tier 1	$4	46%
Patoka Valley Tier 2	$4	46%
UnitedHealthcare	$7	81%
Medicaid / KanCare	$9	104%
Mhs Care Connect	$9	104%
Humana	$20	232%

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 $160.
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 Ascension St Vincent Randolph 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.