Culture, bacterial
Facility: Dukes Memorial Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $18
- Cash Discount Price: $17
- vs. Medicare Baseline: 2.09x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 209% of the Medicare baseline (a markup of 109%). 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.
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 - $82 | 46% |
| Department Of Veterans Affairs | $5 - $47 | 58% |
| Tricare | $5 - $47 | 58% |
| Aetna | $6 - $121 | 70% |
| Humana | $6 - $50 | 70% |
| In Dept Of Correction | $6 - $53 | 70% |
| Iu Health Plan | $6 - $50 | 70% |
| Managed Health Services | $6 - $102 | 70% |
| Medicare (plans) | $6 - $50 | 70% |
| Miami County Sheriffs Department | $6 - $53 | 70% |
| Node Devoted Health Mcr Adv | $6 - $51 | 70% |
| Node Pphp Mcr Adv | $6 - $54 | 70% |
| Node Va | $6 - $123 | 70% |
| UnitedHealthcare | $6 - $125 | 70% |
| Caresource | $8 - $9 | 93% |
| Align Network | $9 - $82 | 104% |
| Lutheran Advanced Network | $9 - $76 | 104% |
| Lutheran Preferred | $9 - $204 | 104% |
| Lutheran Three Rivers Preferred Plus 150 | $9 - $76 | 104% |
| Medicaid / KanCare | $9 | 104% |
| Mhs | $9 | 104% |
| Node Lutheran Preferred Fixed 2 | $9 - $76 | 104% |
| Veterans Eval Services | $9 | 104% |
| Encore Work Comp In | $10 - $92 | 116% |
| Lutheran Three Rivers Preferred Plus 175 | $10 - $89 | 116% |
| Prime Health Services | $10 - $191 | 116% |
| Partners Direct Health Llc | $11 - $97 | 128% |
| Us Department Of Labor | $11 | 128% |
| Cigna | $12 - $255 | 139% |
| Lutheran Northwest Health Preferred | $12 - $102 | 139% |
| Physicians Health Plan | $12 - $119 | 139% |
| Three Rivers Preferred Plus | $12 - $102 | 139% |
| Work Comp | $12 - $102 | 139% |
| Php Freedom | $13 - $118 | 151% |
| Three Rivers Preferred | $13 - $115 | 151% |
| Amish Aid | $14 - $128 | 162% |
| Encore Kba Epo | $14 - $122 | 162% |
| Encore Ppo | $14 - $128 | 162% |
| Self Pay | $14 - $140 | 162% |
| Sagamore Health Network | $16 - $141 | 186% |
| Encore Kba Ppo | $17 - $153 | 197% |
| Consumer Life | $18 - $158 | 209% |
| First Health | $23 - $204 | 267% |
| Multiplan | $23 - $207 | 267% |
| Advantage Health Solutions | $24 - $212 | 278% |
| Encore Health Network | $24 - $209 | 278% |
| Encore | $26 - $230 | 302% |