Culture, bacterial
Facility: Norton County Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $45
- Cash Discount Price: $51
- vs. Medicare Baseline: 5.22x 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 522% of the Medicare baseline (a markup of 422%). 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 | $45 | 522% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Norton County Hospital, the cash median price of $51.00 is notably lower than the facility's negotiated rate of $45.00 and the Medicare benchmark of $8.62. While the negotiated rate appears higher than the cash price, it is important to note that commercial insurance contracts often include administrative overheads that can inflate the baseline price by 20% to 40%. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly may result in lower total costs compared to the insurance negotiated rate, provided the insurance allowed amount does not exceed the cash price.
The facility, a Critical Access Hospital in Norton, KS, operates under a government-local ownership model, which can influence pricing structures. Although the data does not provide specific county or state average comparisons for this exact code, patients are encouraged to verify their specific plan's deductible status before scheduling to avoid unexpected balances. If you choose to pay out-of-pocket, ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the bill by eliminating administrative processing fees associated with insurance claims. Always request a detailed, itemized bill before finalizing payment to ensure all charges are accurate and to identify any potential errors or unbundled codes.