Culture, bacterial
Facility: Wesley Medical Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $236
- Cash Discount Price: $1,049
- vs. Medicare Baseline: 27.38x 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 2738% of the Medicare baseline (a markup of 2638%). 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 |
|---|---|---|
| UnitedHealthcare | $7 | 81% |
| Amerigroup | $8 | 93% |
| Medicaid / KanCare | $8 | 93% |
| Aetna | $8 - $488 | 93% |
| Devoted Health | $9 | 104% |
| Humana | $9 | 104% |
| Coventry Health Care | $9 | 104% |
| Ambetter / Centene | $9 - $246 | 104% |
| Triwest Health Alliance | $9 | 104% |
| United | $9 - $615 | 104% |
| Correct Care Solutions | $13 | 151% |
| First Health | $18 - $630 | 209% |
| Multiplan | $19 - $1,229 | 220% |
| Blue Cross Blue Shield | $22 | 255% |
| Health Partners Of Kansas | $154 - $683 | 1787% |
| Wppa | $155 - $238 | 1798% |
| Preferred Health Choices | $169 - $258 | 1961% |
| Medical Associates Health Plan | $169 - $258 | 1961% |
| Spirit Aerosystems | $285 - $437 | 3306% |
| Triwest Healthcare Alliance | $580 - $888 | 6729% |
| Usa Managed Care | $758 - $1,161 | 8794% |
Consumer Guidance & Cost Commentary
For CPT code 87070, a bacterial culture test at Wesley Medical Center in Wichita, KS, the cash median price is $1,049.00, which matches the facility's gross charge. This cash rate is significantly higher than the state average, as indicated by a 27.4% variance versus Medicare. While commercial insurance plans like UnitedHealthcare and Amerigroup negotiate rates starting around $7, other major payers such as Multiplan and First Health have negotiated rates ranging from $19 to $630. Patients with high-deductible plans may find the cash price of $1,049.00 more affordable than their insurance negotiated rates, which can sometimes exceed the cash amount due to administrative overhead and contract dynamics. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can reduce the final bill by 20% to 50%.
When using insurance, be aware that negotiated rates represent a contractual ceiling rather than the lowest possible price, and some in-network plans may still result in higher out-of-pocket costs than paying cash. The data shows a wide range of negotiated amounts across different payers, with some plans like Health Partners Of Kansas negotiating rates between $154 and $683, while others like Triwest Healthcare Alliance negotiate between $580 and $888. If you receive a bill after insurance processing, ensure you are not being balance billed for out-of-network services, as the No Surprises Act protects patients from such unexpected charges for emergency and non-emergency care at in-network facilities. Furthermore, always request a full item