Culture, bacterial
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $9
- Cash Discount Price: $82
- 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 |
|---|---|---|
| Humana | $8 | 93% |
| Blue Cross Blue Shield | $9 | 104% |
| Aetna | $9 - $11 | 104% |
| United Mine Workers Of America | $9 | 104% |
| Providrs Care Network | $9 | 104% |
| UnitedHealthcare | $9 - $10 | 104% |
| Lantern Specialty Care | $14 | 162% |
Consumer Guidance & Cost Commentary
For the bacterial culture procedure (CPT 87070) at Kansas Spine & Specialty Hospital, Llc, the cash median price is $82.00, while the facility's negotiated rate with insurance payers averages $9.00. This facility is located in Wichita, KS, and serves seven different insurance plans, including Humana, Blue Cross Blue Shield, and UnitedHealthcare. It is important to note that while cash payments can sometimes be more expensive than insurance negotiated rates, this specific service shows a significantly lower negotiated amount. Patients should verify their specific plan's allowed amount before scheduling, as in-network rates vary by carrier. Additionally, if a patient has a high deductible and has not yet met their out-of-pocket maximum, paying the cash price of $82.00 upfront might result in lower total out-of-pocket costs compared to the insurance negotiated rate of $9.00, depending on their specific plan structure and whether the insurance payment would be applied toward their deductible.
To ensure you are receiving fair pricing, it is recommended to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. While this facility lists a "Physician" ownership type, patients should confirm if any ancillary services, such as lab supplies or specific testing components, are billed separately or out-of-network, which could trigger balance billing under certain circumstances. Although the No Surprises Act protects patients from balance billing for emergency care and non-emergency services at in-network facilities, it is prudent to ask the billing department about any potential out-of-network components prior to treatment. Finally, patients should inquire about prompt-pay