Culture, bacterial
Facility: Kansas Medical Center Llc
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $9
- Cash Discount Price: $25
- 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 |
|---|---|---|
| United | $3 | 35% |
| Medicaid / KanCare | $7 | 81% |
| Indian Health | $8 | 93% |
| Blue Cross Blue Shield | $9 - $19 | 104% |
| Medadv_Wellcare | $9 | 104% |
| Ambetter / Centene | $9 | 104% |
| Humana | $9 | 104% |
| Wppa | $12 - $35 | 139% |
| Three_Rivers | $17 | 197% |
| Aetna | $27 | 313% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Kansas Medical Center Llc in Andover, the cash price of $25.00 is notably lower than the facility's negotiated rates, which range from $9.00 to $35.00 depending on the insurance plan. While the facility's cash rate is significantly below the gross charge of $42.00, it is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $25.00 upfront could result in immediate savings compared to the higher amounts their insurance might negotiate. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the standard insurance billing cycle and lower the final cost.
When evaluating the value of this service, it is essential to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this code is $8.62, which serves as the objective baseline for fair pricing; commercial rates typically range from 200% to 300% of this figure, while fair pricing is generally defined as 120% to 150%. Although the data does not provide specific state or county average comparisons for this exact code, the facility's cash rate of $25.00 represents a 186% markup over the Medicare rate, which falls within the upper range of typical commercial pricing but remains lower than the highest negotiated rates observed. To ensure you are not overpaying, request a full itemized bill