Culture, bacterial
Facility: Stevens County Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $58
- Cash Discount Price: $108
- vs. Medicare Baseline: 6.73x 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 673% of the Medicare baseline (a markup of 573%). 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 |
|---|---|---|
| Aetna | $6 - $150 | 70% |
| Humana | $24 - $56 | 278% |
| Blue Cross Blue Shield | $30 - $32 | 348% |
| First Health - All Plans | $58 - $135 | 673% |
| Wppa - All Plans | $62 - $142 | 719% |
| Medicaid / KanCare | $65 - $150 | 754% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Stevens County Hospital in Hugoton, Kansas, the cash price is $108.00, which matches the facility's median paid amount. While the hospital's negotiated rates with major payers like Aetna and Humana range from $6 to $150, the cash price can sometimes be the most economical option for patients with high-deductible plans or those who have already met their out-of-pocket limits. It is important to note that the facility is a Critical Access Hospital owned by the local government, and patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final bill by bypassing costly insurance claims processing.
When comparing this service to broader benchmarks, the facility's cash rate of $108.00 is notably higher than the Medicare benchmark of $8.62, reflecting a significant markup common in commercial billing. However, the median negotiated rate of $58.00 is lower than the cash price, suggesting that for many insured patients, the insurance allowed amount will be less than the cash price they would pay directly. To ensure you are receiving the best possible rate, you should request an itemized bill to verify that no services were unbundled or double-charged, and remember that the No Surprises Act protects you from balance billing for out-of-network services at this in-network facility.