Culture, bacterial
Facility: Lincoln County Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $32
- Cash Discount Price: $114
- vs. Medicare Baseline: 3.71x 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 371% of the Medicare baseline (a markup of 271%). 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 | 371% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Lincoln County Hospital, the cash price of $114.00 is significantly lower than the negotiated rate of $32.00 paid by Blue Cross Blue Shield, which represents the only payer in this dataset. While the facility is a Critical Access Hospital in Lincoln, Kansas, with government-local ownership, the cash price is notably higher than the state average for this procedure. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price directly, as the insurance negotiated rate exceeds the cash amount. To secure the lowest possible cost, we recommend asking the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the bill if paid in full upfront.
It is important to understand that commercial insurance rates often include administrative overhead and contract markups that can inflate the final cost compared to direct cash payment. Although the Medicare benchmark for this service is $8.62, the cash price of $114.00 reflects the facility's actual cost basis and local market dynamics rather than the federal baseline. If you are billed by an out-of-network provider, you may be subject to balance billing for the difference between the provider's full charge and your insurance allowed amount, though the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. Always request an itemized bill before paying to ensure no unbundled codes or services not rendered are included, and never accept a summary bill as your final invoice.