Culture, bacterial
Facility: F W Huston Medical Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $100
- Cash Discount Price: $104
- vs. Medicare Baseline: 11.60x 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 1160% of the Medicare baseline (a markup of 1060%). 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% |
| Aetna | $98 | 1137% |
| Humana | $103 | 1195% |
| Cigna | $110 | 1276% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at F W Huston Medical Center in Winchester, KS, the facility's cash price of $104.00 is notably lower than the state average, which sits at $130.00. While the facility's negotiated rates with major insurers like Blue Cross Blue Shield, Aetna, Humana, and Cigna range from $98.00 to $110.00, these amounts are generally higher than the cash price. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $104.00 may result in immediate savings compared to the insurance negotiated rates, which can exceed $100.00. It is important to note that while the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify their specific plan details before scheduling, as insurance coverage varies significantly by individual policy.
Regarding billing transparency, patients should be aware that commercial insurance rates often include administrative overhead that can inflate the final cost beyond the true cost of care. The Medicare benchmark for this service is $8.62, which serves as a scientifically validated baseline for the actual cost of delivery; commercial negotiated rates typically range from 120% to 150% of this amount, whereas the facility's cash price is competitive with the state average. If a patient receives an unexpected bill after insurance processing, they should request an itemized audit to identify any errors, such as unbundled codes or services not rendered, as over 80% of hospital bills contain inaccuracies. Additionally, patients should inquire about prompt-pay discounts, which can reduce the cash price