Culture, bacterial
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $9
- Cash Discount Price: $86
- 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 |
|---|---|---|
| UnitedHealthcare | $7 - $24 | 81% |
| Medicaid / KanCare | $8 | 93% |
| Smarthealth | $8 - $12 | 93% |
| Aetna | $8 | 93% |
| Providrs Care | $9 | 104% |
| Humana | $9 | 104% |
| Va | $9 | 104% |
| Medicare (plans) | $9 | 104% |
| Ambetter / Centene | $15 | 174% |
| Blue Cross Blue Shield | $53 - $347 | 615% |
Consumer Guidance & Cost Commentary
For the bacterial culture service (CPT 87070), Ascension Via Christi Hospital Manhattan lists a cash median price of $86.00, which is significantly lower than the facility's gross charge of $216.00. While the hospital offers a negotiated rate of $9.00 to insurance payers like Medicaid/KanCare and Smarthealth, this amount is still higher than the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that commercial insurance rates often include administrative overhead and do not reflect the true cost of care; comparing these rates to the Medicare benchmark of $8.62 reveals a substantial markup, whereas the cash rate aligns much closer to the actual cost basis.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected charges can still occur if ancillary services are out-of-network. To avoid surprise bills, individuals should request a full itemized audit of their statement before paying, as summary bills often hide unbundled codes or services not rendered. Additionally, because hospitals frequently offer prompt-pay discounts for upfront payment, patients should explicitly ask the billing department for self-pay or cash-pay rates prior to scheduling any appointments to ensure they are not inadvertently triggering insurance claims that void potential discounts.