Culture, bacterial
Facility: Kiowa District Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $57
- Cash Discount Price: $50
- vs. Medicare Baseline: 6.61x 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 661% of the Medicare baseline (a markup of 561%). 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 |
|---|---|---|
| Healthchoice-All Plans | $13 | 151% |
| Tricare | $17 - $25 | 197% |
| Blue Cross Blue Shield | $32 | 371% |
| UnitedHealthcare | $35 - $64 | 406% |
| Health Partners Of Ks-All Plans | $39 - $56 | 452% |
| Humana | $40 - $58 | 464% |
| Gbs Insurance - All Plans | $41 - $60 | 476% |
| Multiplan-All Plans | $41 - $60 | 476% |
| Medicare (plans) | $42 - $61 | 487% |
| Triwest-All Plans | $42 - $61 | 487% |
| Aetna | $42 - $61 | 487% |
| Medicaid / KanCare | $44 - $64 | 510% |
| Providers Care (Wppa)-All Plans | $66 - $96 | 766% |
| Liberty Healthshare-All Plans | $71 - $103 | 824% |
Consumer Guidance & Cost Commentary
For the CPT code 87070 (Culture, bacterial) at Kiowa District Hospital, the cash price of $50.00 is lower than the facility's negotiated rates, which range from $13 to $103 depending on the payer. While the facility's cash median of $50.00 is below the gross charge of $62.00, patients should note that insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For individuals with high-deductible plans, paying the cash price upfront may result in lower out-of-pocket costs compared to the allowed amounts charged by commercial payers like UnitedHealthcare or Providers Care. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these can further reduce the final bill before any insurance processing occurs.
When evaluating this charge against broader benchmarks, the Medicare amount of $8.62 serves as the objective baseline for cost, illustrating that commercial rates are typically marked up significantly above this federal standard. Although the data does not provide specific state or county average figures for this code, the facility's ownership by a Government Hospital District and its classification as a Critical Access Hospital in Kiowa, KS, suggest that pricing may be influenced by local wage indexes and regional cost structures. Patients should request an itemized billing audit to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.