Culture, bacterial
Facility: Stafford County Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $52
- Cash Discount Price: $90
- vs. Medicare Baseline: 6.03x 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 603% of the Medicare baseline (a markup of 503%). 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 |
|---|---|---|
| Va Ccn-All Plans | $1 - $10 | 12% |
| UnitedHealthcare | $1 - $10 | 12% |
| Humana | $15 - $113 | 174% |
| Medica Mcr- All Plans | $15 - $113 | 174% |
| Health Partners-All Plans | $15 - $108 | 174% |
Consumer Guidance & Cost Commentary
For CPT code 87070, a bacterial culture performed at Stafford County Hospital in Stafford, KS, the cash median price is $90.00, which matches the facility's negotiated median paid rate. This service is provided by a Critical Access Hospital owned by the local government. While the facility's cash price is $90.00, it is important to note that commercial insurance negotiated rates for this service average $52.00, which is lower than the cash price. However, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds $90.00, as paying the full cash price could result in lower out-of-pocket costs compared to meeting a high deductible and then paying the negotiated rate.
The facility's pricing is benchmarked against the Medicare rate of $8.62, which serves as a scientifically validated baseline for healthcare costs. Although the cash price of $90.00 is significantly higher than the Medicare rate, this markup is common for commercial services that include administrative overhead and contract management. Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like lab tests are billed separately. To minimize costs, patients are encouraged to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, and to request an itemized bill to verify that no services were unbundled or double-charged.