Culture, bacterial
Facility: Osborne County Memorial Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $51
- Cash Discount Price: $49
- vs. Medicare Baseline: 5.92x 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 592% of the Medicare baseline (a markup of 492%). 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 |
|---|---|---|
| UnitedHealthcare | $36 - $52 | 418% |
| Health Partners Of Kansas | $40 - $58 | 464% |
| Wppa | $45 - $65 | 522% |
| Blue Cross Blue Shield | $46 - $67 | 534% |
Consumer Guidance & Cost Commentary
For the CPT code 87070 (Culture, bacterial), the facility's cash median price of $49.00 is lower than the gross charge of $58.00, offering a potential savings for self-pay patients. While the negotiated rates for in-network payers like UnitedHealthcare and Health Partners of Kansas range from $40 to $67, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that the cash median of $49.00 is significantly higher than the Medicare amount of $8.62, which serves as the federal baseline for cost. To minimize costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative overhead associated with insurance billing cycles.
The facility, Osborne County Memorial Hospital, is a Critical Access Hospital located in Osborne, KS, with a facility ownership structure of Government - Local. While specific state or county average data was not provided in the source material, the facility's pricing dynamics highlight the importance of comparing commercial rates against the Medicare benchmark. Because commercial negotiated rates often include administrative markups that can inflate the baseline price by 20% to 40%, consumers should verify the exact allowed amount with their insurer before assuming the in-network rate is the lowest possible. If a patient receives an itemized bill that appears inflated, they should request a line-by-line review to identify any unbundled codes or services not rendered, ensuring the final charge aligns with the negotiated or cash rates discussed.