Culture, bacterial
Facility: Lane County Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $95
- Cash Discount Price: $95
- vs. Medicare Baseline: 11.02x 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 1102% of the Medicare baseline (a markup of 1002%). 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 |
|---|---|---|
| Aetna | $51 - $120 | 592% |
| UnitedHealthcare | $51 - $126 | 592% |
| Medicaid / KanCare | $57 - $139 | 661% |
| Healthy Blue Mcaid | $57 - $126 | 661% |
| Healthy Blue Mcr Adv - All Other Plans | $57 - $126 | 661% |
| Wppa Providers-All Plans | $86 - $189 | 998% |
Consumer Guidance & Cost Commentary
For the CPT code 87070 (Culture, bacterial) at Lane County Hospital in Dighton, KS, the cash price is $95.00, which matches the facility's negotiated rate and the median paid amount. This cash price is significantly higher than the Medicare benchmark of $8.62, indicating a markup of 11.0% above the federal baseline. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $51 to $139, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the $95.00 cash rate directly rather than relying on insurance, provided they have not met their deductible.
Patients should verify if the facility offers self-pay or prompt-pay discounts before scheduling, as paying upfront can sometimes reduce the final bill further. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. To ensure accuracy, consumers should request a full itemized bill rather than accepting a summary invoice, as hospitals may bundle costs or include services not rendered. Comparing this specific service to local averages is not possible with the current data, but understanding the difference between the cash price and the Medicare rate helps clarify the true cost of care.