Culture, bacterial
Facility: Rawlins County Health Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $50
- Cash Discount Price: $65
- vs. Medicare Baseline: 5.80x 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 580% of the Medicare baseline (a markup of 480%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $32 | 371% |
| UnitedHealthcare | $50 - $83 | 580% |
Consumer Guidance & Cost Commentary
For the bacterial culture service (CPT 87070) at Rawlins County Health Center in Atwood, KS, the cash median price is $65.00, which is significantly lower than the facility's gross charge of $76.00. While the facility is a Critical Access Hospital with voluntary non-profit ownership, patients should be aware that commercial insurance rates can sometimes exceed cash prices. For instance, UnitedHealthcare's negotiated rate ranges from $50.00 to $83.00 across four plans, meaning a patient with a high deductible might save money by paying the cash price of $65.00 directly, provided they have not yet met their deductible. It is crucial to verify your specific plan's allowed amount before scheduling, as assuming in-network status guarantees the lowest price is a common pitfall; some in-network facilities charge substantially more than others for the same service.
To ensure you are not overcharged, always request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you receive a bill from an out-of-network provider, the No Surprises Act generally protects you from balance billing for emergency care and non-emergency services at in-network facilities, so do not sign away your rights via consent waivers without reading them carefully. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you pay in full upfront, bypassing the administrative costs associated with insurance claims processing. Finally, compare all rates against the Medicare benchmark of $8.62; since fair pricing