Culture, bacterial
Facility: Phillips County Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $42
- Cash Discount Price: $37
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $32 - $36 | 371% |
| UnitedHealthcare | $34 - $44 | 394% |
| Medicaid / KanCare | $42 - $44 | 487% |
| Health Partners-All Plans | $42 - $44 | 487% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Phillips County Hospital, the cash median price of $37.00 is notably lower than the negotiated rates paid by major payers, which range from $32 to $44 depending on the specific plan. While the facility's negotiated average of $42.00 is higher than the cash price, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance allowed amount exceeds the cash rate. It is important to note that Medicaid/KanCare plans in this region have negotiated rates between $42 and $44, which align closely with the facility's negotiated average.
To ensure you receive the most accurate pricing, always ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the final bill by 20% to 50%. Additionally, if you are using insurance, be aware that commercial negotiated rates often include administrative overhead that can inflate the baseline price by 20% to 40% compared to the true cost of care. For context, the Medicare benchmark for this service is $8.62, which serves as a federal cost baseline; commercial rates are typically higher than this figure due to the added costs of claims processing and network agreements.