Culture, bacterial
Facility: Cloud County Health Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $58
- Cash Discount Price: $44
- 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 | $47 - $68 | 545% |
| Mpi-All Plans | $50 - $70 | 580% |
| Pponext-All Plans | $50 - $70 | 580% |
| Health Partners - All Plans | $50 - $70 | 580% |
Consumer Guidance & Cost Commentary
For the CPT code 87070, representing a bacterial culture at Cloud County Health Center in Concordia, KS, the facility's cash median price is $44.00, which is lower than the state average of $58.00. While the facility's negotiated rates with major payers like Aetna and Mpi-All Plans range between $50 and $70, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $44.00. It is important to note that commercial negotiated rates often include administrative overhead and contract markups, making the direct cash price a valuable benchmark for self-pay patients.
To ensure you are receiving the most accurate pricing, always request an itemized bill before finalizing payment, as summary invoices can obscure individual code costs and potential errors. If you choose to pay out-of-pocket, ask specifically about "self-pay" or "prompt-pay" discounts, which can reduce the final amount by 20% to 50% if settled upfront. Additionally, while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is crucial to verify your plan's status and avoid signing consent waivers that might inadvertently waive your rights to dispute unexpected charges.