Culture, bacterial
Facility: Overland Park Reg Med Ctr
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $101
- Cash Discount Price: $1,075
- vs. Medicare Baseline: 11.72x 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 1172% of the Medicare baseline (a markup of 1072%). 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 |
|---|---|---|
| Cigna | $4 - $9 | 46% |
| Amerigroup | $7 | 81% |
| United | $7 - $493 | 81% |
| Healthyblue | $8 | 93% |
| Home State Health Plan | $8 | 93% |
| Aetna | $8 - $559 | 93% |
| Medicaid / KanCare | $8 | 93% |
| Unicare | $8 | 93% |
| Triwest Health Alliance | $9 | 104% |
| Celtic | $9 | 104% |
| Wellcare | $9 | 104% |
| Coventry | $9 - $441 | 104% |
| Pyramid Life | $9 | 104% |
| Blue Cross Blue Shield | $9 - $471 | 104% |
| Humana | $9 - $21 | 104% |
| Devoted Health | $9 | 104% |
| Oscar | $13 | 151% |
| Multiplan | $16 - $811 | 186% |
| Corvel Corporation | $18 - $712 | 209% |
| Oha Network | $19 - $548 | 220% |
| Ambetter / Centene | $44 - $204 | 510% |
| Nhc Advantage | $44 - $208 | 510% |
| Wppa Providrs Care Network | $47 - $219 | 545% |
| Universal Healthcare | $82 - $384 | 951% |
| Coventry Kc Mo | $96 - $449 | 1114% |
| College Park Family Care Center | $101 - $471 | 1172% |
| Focus Healthcare Mgmt, Inc | $176 - $822 | 2042% |
| Cco, Inc. | $176 - $822 | 2042% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Overland Park Reg Med Ctr, the cash price is $1,075, which matches the facility's median paid amount. While many commercial payers have negotiated rates ranging from $4 to $822 depending on the specific plan, the cash rate remains the highest figure listed. It is important to note that for patients with high-deductible plans, paying the cash price upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rates paid by insurers often exceed the cash price. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full within a short window, bypassing the administrative costs associated with insurance claims processing.
When comparing this facility's pricing to broader benchmarks, the cash rate of $1,075 is significantly higher than the Medicare amount of $8.62, reflecting a markup typical of commercial billing structures. The facility's negotiated rates average $101, which is notably lower than the cash price, suggesting that for those with active insurance coverage, the allowed amount will be substantially less than the cash charge. However, patients must be aware of balance billing risks if they are out-of-network, where the provider could bill the difference between the negotiated rate and the cash price. To ensure accuracy and avoid unexpected costs, consumers should request an itemized bill before payment and verify that all services rendered are correctly coded, as over 80% of hospital bills contain errors that can be disputed.