Culture, bacterial
Facility: Saint John Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $9
- Cash Discount Price: $8
- vs. Medicare Baseline: 1.04x 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.
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 |
|---|---|---|
| Medicaid / KanCare | $7 | 81% |
| UnitedHealthcare | $7 - $12 | 81% |
| Healthy Blue | $8 - $9 | 93% |
| Celtic | $8 - $55 | 93% |
| Midland Care Connection | $9 | 104% |
| Kansas Superior Select | $9 | 104% |
| Cigna | $9 | 104% |
| Medicare (plans) | $9 | 104% |
| Aetna | $9 - $15 | 104% |
| Tricare | $9 | 104% |
| Well Path | $12 | 139% |
| Corizon | $12 | 139% |
| Employer Direct Healthcare | $12 | 139% |
| Centurion | $13 | 151% |
| Naphcare | $13 | 151% |
| Blue Cross Blue Shield | $15 - $32 | 174% |
| Comp Alliance Workers Comp | $18 | 209% |
| Worker Compensation | $19 | 220% |
| Oha Networks | $19 | 220% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Saint John Hospital in Leavenworth, KS, the cash-pay median rate is $8.00, which is significantly lower than the facility's negotiated rates ranging from $7 to $55 across various payers. While the hospital's cash price is notably lower than its gross charge of $157.00, patients with high-deductible plans or those without insurance may find the cash option most economical, as the negotiated rates for in-network plans often exceed the cash price. It is important to note that while the facility offers a cash median of $8.00, the actual self-pay or prompt-pay discount should be confirmed directly with the hospital before scheduling, as these rates can vary and may offer further reductions for upfront payment.
The facility's pricing structure is anchored by a Medicare benchmark of $8.62, which serves as a scientifically validated baseline for the true cost of care. Commercial negotiated rates for this service vary widely, with some payers like Medicaid/KanCare and UnitedHealthcare negotiating amounts as high as $12, while others like Celtic and Blue Cross Blue Shield have ranges extending up to $55 and $32 respectively. This disparity highlights that being in-network does not guarantee the lowest possible price, as administrative costs and contract dynamics can inflate the allowed amount well above the Medicare rate. To avoid unexpected balance billing or summary bills that obscure individual charges, patients should request a full itemized CPT-coded statement and verify their specific plan's allowed amount before receiving care.