Culture, bacterial
Facility: Hospital District #6 Patterson Health Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $42
- Cash Discount Price: $36
- vs. Medicare Baseline: 4.87x 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 487% of the Medicare baseline (a markup of 387%). 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 |
|---|---|---|
| UnitedHealthcare | $27 - $60 | 313% |
| Blue Cross Blue Shield | $30 - $32 | 348% |
| Providers Care (Wppa)-All Plans | $52 - $105 | 603% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median rate of $36.00 is lower than the state average of $41.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $27 to $105, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. The facility, a Critical Access Hospital owned by the government, lists a cash median of $36.00, which is notably lower than the median paid amount of $41.00 for insured patients. To secure the best price, consumers should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can bypass the administrative costs associated with insurance billing cycles.
When reviewing your final bill, it is crucial to request a detailed itemized statement rather than accepting a summary invoice that may hide errors or unbundled charges. Since over 80% of hospital bills contain mistakes, such as double-billing or charges for services not rendered, verifying the exact CPT codes and unit costs is essential before making any payments. Additionally, while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, unexpected out-of-network ancillary services like specific lab tests could still trigger surprise bills if not carefully reviewed. Always compare the facility's rates against the Medicare benchmark of $8.62 to understand the true cost basis, as commercial rates often include significant administrative markups that do not reflect the actual cost of care delivery.