Culture, bacterial
Facility: Minneola District Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $41
- Cash Discount Price: $32
- vs. Medicare Baseline: 4.76x 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 476% of the Medicare baseline (a markup of 376%). 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 | $30 - $45 | 348% |
| Va Community Care Program-All Plans | $30 | 348% |
| Humana | $30 | 348% |
| Blue Cross Blue Shield | $32 | 371% |
| Corporate Plan Management-All Plans | $38 | 441% |
| Providrs Care Network-All Plans | $38 | 441% |
| Preferred Health Care (Coventry)-All Other Plans | $40 | 464% |
| Triwest-All Plans | $40 | 464% |
| Health Partners Of Kansas-All Plans | $43 | 499% |
| Aetna | $43 - $45 | 499% |
| Phc (Coventry) Leased Network | $43 | 499% |
| Medicaid / KanCare | $45 | 522% |
Consumer Guidance & Cost Commentary
For this specific bacterial culture service (CPT 87070), the facility's cash median rate of $32.00 is notably lower than the state average of $39.00, making it a potentially cost-effective option for patients paying out-of-pocket. While the facility's negotiated rates range from $30 to $45 depending on the insurance plan, these amounts often exceed the cash price, which can be advantageous for individuals with high-deductible plans who may not yet have met their coverage thresholds. Because the facility is a Critical Access Hospital in Minneola, KS, and operates under government ownership, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes bypass the higher administrative costs associated with insurance billing.
It is important to compare these figures against the Medicare benchmark of $8.62 to understand the true cost baseline, as commercial rates frequently exceed this federal standard due to administrative overhead and contract dynamics. Although the facility's gross charge is $45.00, the actual amounts paid by insurers vary, with the lowest negotiated rate being $30.00 and the highest being $45.00 across twelve different payers. Patients should avoid relying on the gross charge as a benchmark for savings, as hospitals often inflate list prices to make discounts appear larger than they are; instead, verifying the specific allowed amount for your plan is the most effective way to determine if the facility is charging a fair price relative to the Medicare rate.