CMS Price Transparency Data

Culture, bacterial

Facility: Rush Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $178
Cash Discount Price: $245
vs. Medicare Baseline: 20.65x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Rush Memorial Hospital is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $245. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 20.65x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$245

Average discount available for prompt cash payment at this facility.

Insurance Median

$178

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: $245 (2842%)

Insurance Median: $178 (2065%)

Cash: $245 (2842% of Medicare)

Ins. Median: $178 (2065% 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 2065% of the Medicare baseline (a markup of 1965%). 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
Health Net	$13 - $348	151%
Aetna	$14 - $1,086	162%
Blue Cross Blue Shield	$14 - $864	162%
Caresource Mcr Adv	$14 - $366	162%
Humana	$14 - $1,086	162%
My True Advantage - All Plans	$14 - $366	162%
Today'S Option Mcr Adv-All Plans	$14 - $377	162%
UnitedHealthcare	$14 - $944	162%
Viant Beech St Mcr Adv	$14 - $377	162%
Caresource Marketplace-All Other Plans	$22 - $585	255%
Cigna	$35 - $944	406%
Phcs-All Plans	$35 - $944	406%
Consumers Life Ins-All Plans	$39 - $1,062	452%
Coventry/First Health-All Plans	$39 - $1,062	452%
Sagamore-All Plans	$40 - $1,086	464%
Siho-All Plans	$40 - $1,086	464%
Community Health Alliance-All Plans	$41 - $1,109	476%
Multiplan-All Plans	$41 - $1,097	476%
Encore Health Services-All Plans	$43 - $1,156	499%

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 $245.
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 Rush 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.