Culture, bacterial
Facility: Stanton County Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $114
- Cash Discount Price: $92
- vs. Medicare Baseline: 13.23x 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 1323% of the Medicare baseline (a markup of 1223%). 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 | $30 - $230 | 348% |
| Healthy Blue Mcr Adv - All Other Plans | $113 - $238 | 1311% |
| Healthy Blue Mcaid | $116 - $207 | 1346% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Stanton County Hospital, the cash price is $92.00, which matches the cash median for this procedure. While the facility's negotiated rates with major payers like Blue Cross Blue Shield range from $30 to $230, and the median negotiated amount is $114.00, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash rate. It is important to note that the facility is a Critical Access Hospital in Johnson, KS, and while specific state or county average data for this procedure was not provided in the report, patients should always verify their specific plan's allowed amount before scheduling to ensure they are not facing balance billing if the provider is out-of-network.
The Medicare benchmark for this service is $8.62, which serves as a baseline to evaluate the facility's pricing; the cash price of $92.00 represents a significant markup over this federal rate. Commercial negotiated rates typically average 200% to 300% of Medicare, though fair pricing is often defined as 120% to 150%, so comparing your insurance allowed amount directly to the Medicare rate provides a clearer picture of value than comparing it to the hospital's gross charges. To potentially lower your final bill, you should contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce costs by 20% to 50% if you pay in full upfront, and request a detailed itemized bill to ensure no errors or unbundled charges are included in your total.