Culture, bacterial
Facility: Satanta District Hospital, Clinics, & Ltcu
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $40
- Cash Discount Price: $59
- vs. Medicare Baseline: 4.64x 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 464% of the Medicare baseline (a markup of 364%). 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 |
|---|---|---|
| Direct Benefit-All Plans | $11 - $21 | 128% |
| UnitedHealthcare | $13 - $87 | 151% |
| Berkley Net-All Plans | $18 - $35 | 209% |
| Aetna | $19 - $59 | 220% |
| Trustmark Health Benefits-All Plans | $19 - $38 | 220% |
| Meritain Health-All Plans | $20 - $39 | 232% |
| Ambetter / Centene | $21 - $42 | 244% |
| Axa Equitable - All Plans | $24 - $48 | 278% |
| Medi-Share-All Plans | $25 - $50 | 290% |
| Pinnacol-All Plans | $25 - $49 | 290% |
| Presbyterian-All Plans | $27 - $53 | 313% |
| Kasb Work Comp - All Plans | $28 - $56 | 325% |
| The Kempton Group Admin-All Plans | $30 - $60 | 348% |
| Wppa- All Plans | $31 - $62 | 360% |
| Auxiant - All Plans | $31 - $61 | 360% |
| Gpha(Wppa)-All Other Plans | $31 - $61 | 360% |
| Emc-All Plans | $32 - $63 | 371% |
| Providers Care Network- All Plans | $32 - $63 | 371% |
| Gpha Employee Benefit Plan | $32 - $64 | 371% |
| Sisco-All Plans | $32 - $63 | 371% |
| Employee Benefit-All Plans | $33 - $65 | 383% |
| Regional Care(Wppa)-All Plans | $33 - $65 | 383% |
| First Health -All Plans | $33 - $66 | 383% |
| Triangle-All Plans | $33 - $66 | 383% |
| One Call Physician-All Plans | $34 - $67 | 394% |
| Christian Hospital Aid - All Plans | $35 - $70 | 406% |
| Tricare | $35 - $70 | 406% |
| Blue Cross Blue Shield | $35 - $69 | 406% |
| Humana | $38 - $75 | 441% |
| Cigna | $39 - $77 | 452% |
| Luminare Health- All Plans | $39 - $77 | 452% |
| Deseret Mutual(Uhis)-All Plans | $40 - $78 | 464% |
| Coresource-All Plans | $40 - $78 | 464% |
| Vaccn-All Plans | $40 - $80 | 464% |
| Reserve National-All Plans | $42 - $83 | 487% |
| Wps Vapc-All Plans | $42 - $83 | 487% |
| Hma Llc-All Plans | $42 - $83 | 487% |
| Medicaid / KanCare | $44 - $87 | 510% |
Consumer Guidance & Cost Commentary
For the bacterial culture service (CPT 87070) at Satanta District Hospital, the cash median price is $59.00, which is lower than the facility's gross charge of $66.00. While the facility's negotiated rates with insurance payers range from $11 to $87, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds $59.00. It is important to note that this facility is a Critical Access Hospital in Kansas, and while the specific county average is not provided in this data, the cash rate is significantly lower than the highest negotiated rates observed, such as the $87.00 maximum for Medicaid/KanCare plans.
To minimize out-of-pocket costs, patients should proactively ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. If you are using insurance, be aware that balance billing is generally prohibited for emergency services at in-network facilities under the No Surprises Act, though unexpected charges can still occur for out-of-network ancillary services. If you receive a bill, always request a full itemized statement rather than accepting a summary invoice, and compare the final allowed amount against the Medicare benchmark of $8.62 to ensure you are not being overcharged relative to the federal cost baseline.