CMS Price Transparency Data

Culture, bacterial

Facility: Woodlawn Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $47
  • Cash Discount Price: $159
  • vs. Medicare Baseline: 5.45x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Woodlawn Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 5.45x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.
Cash / Self-Pay
$159

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $159 (1845%)
Insurance Median: $47 (545%)
Cash: $159 (1845% of Medicare)
Ins. Median: $47 (545% 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 545% of the Medicare baseline (a markup of 445%). 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
Blue Cross Blue Shield $4 - $161 46%
Caresource Mcaid Hww $9 104%
Mdwise Excel Hhw & Hcc $9 104%
Mhs Mcaid Hcc $9 104%
Mhs Mcaid Hhw $9 104%
UnitedHealthcare $9 - $161 104%
Partners Direct Health-All Plans $18 209%
Aetna $47 - $201 545%
Caresource Mcaid Hip $47 545%
Caresource Mcr Adv $47 545%
Humana $47 - $165 545%
Mdwise Mcaid Excel Hip $47 545%
Mhs Exch Mrktplce-All Other Plans $47 545%
Mhs Mcaid Hip $47 545%
Mhs Mcr Adv $48 557%
Caresource Exch - All Other Plans $61 708%
Ambetter / Centene $62 719%
Cigna $152 - $180 1763%
Parkview Health Plans-All Plans $159 1845%
Sagamore All Other Grps - All Other Plans $178 2065%
Encore Comm-All Plans $180 2088%
Phcs/Multiplan-All Plans $197 2285%
Community Health Alliance-All Plans $201 2332%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 E 9Th St, Rochester, IN 46975
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals