Culture, bacterial
Facility: St Luke Hospital & Living Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $53
- Cash Discount Price: Unavailable
- 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 |
|---|---|---|
| Kansas Department Of Health And Environment | $52 - $55 | 603% |
| Blue Cross Blue Shield | $52 - $55 | 603% |
| Humana | $52 - $55 | 603% |
| Va Ccn | $52 - $55 | 603% |
| Ambetter / Centene | $52 - $55 | 603% |
| UnitedHealthcare | $52 - $55 | 603% |
| Bluestem Pace | $52 - $55 | 603% |
Consumer Guidance & Cost Commentary
For the CPT code 87070, "Culture, bacterial," St Luke Hospital & Living Center in Marion, KS, has a gross charge of $104.00. This facility is a Critical Access Hospital owned by a Government Hospital District. While the facility does not list specific cash or median paid rates, the negotiated rate across seven payers averages $53.00. This negotiated amount is significantly lower than the gross charge, reflecting standard insurance contracts. For patients with high-deductible plans, it is important to note that cash-pay rates can sometimes be cheaper than the insurance negotiated rate if the latter exceeds the cash price, though specific cash pricing is not available for this service.
When comparing this service to broader benchmarks, the facility's pricing context is defined by its status as a Critical Access Hospital. The Medicare amount for this procedure is $8.62, which serves as the objective baseline for evaluating the facility's markup. The provided data indicates a variance of 6.1% against Medicare, suggesting the facility's pricing aligns closely with federal cost standards rather than the typical commercial markups seen in other settings. Consumers should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should always request an itemized bill to verify that no unbundled codes or services not rendered are included before finalizing payment.