Culture, bacterial
Facility: Wilson Medical Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $53
- Cash Discount Price: $50
- vs. Medicare Baseline: 6.15x 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 615% of the Medicare baseline (a markup of 515%). 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 | $32 - $66 | 371% |
| Tricare | $35 | 406% |
| Ambetter / Centene | $35 - $66 | 406% |
| UnitedHealthcare | $35 - $61 | 406% |
| Aetna | $35 - $66 | 406% |
| Humana | $35 | 406% |
| Cigna | $53 | 615% |
| Health Partners-All Plans | $61 | 708% |
| Mulitplan-All Plans | $61 | 708% |
Consumer Guidance & Cost Commentary
For the CPT code 87070 (Culture, bacterial) at Wilson Medical Center in Neodesha, KS, the facility's negotiated rates range from $35 to $66, with a median paid amount of $35. This aligns closely with the state average, as the median negotiated rate across all payers is also $53, while the cash median is $50. Notably, the facility's negotiated rate is 6.1% higher than the Medicare benchmark of $8.62, which serves as the objective baseline for fair pricing. While the gross charge is $66, patients should be aware that commercial insurance rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40% compared to the true cost of care.
Patients with high-deductible plans may find that paying the cash median of $50 upfront is more cost-effective than relying on insurance, which could result in a negotiated rate exceeding the cash price. It is important to verify your deductible status before scheduling, as paying out-of-pocket can sometimes bypass the higher negotiated rates charged to insured members. Additionally, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can offer significant fee reductions for upfront payment. Since over 80% of hospital bills contain errors, do not accept a summary bill as final; instead, request a detailed, itemized statement to ensure all charges are accurate and to identify any unbundled codes or services not rendered.