Culture, bacterial
Facility: Hodgeman County Health Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $66
- Cash Discount Price: $70
- vs. Medicare Baseline: 7.66x 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 766% of the Medicare baseline (a markup of 666%). 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 | $30 - $32 | 348% |
| Triwest - All Plans | $49 - $64 | 568% |
| Medicaid / KanCare | $49 - $100 | 568% |
| UnitedHealthcare | $49 - $95 | 568% |
| Humana | $49 - $64 | 568% |
| Aetna | $61 - $80 | 708% |
| First Health - All Plans | $68 - $90 | 789% |
| Wppa (Provdrscare) - All Plans | $72 - $95 | 835% |
| Health Partners - All Plans | $72 - $95 | 835% |
Consumer Guidance & Cost Commentary
For the CPT code 87070, representing a bacterial culture at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash median rate is $70.00, while the median negotiated rate for insurance payers is $66.00. This service is provided by a Critical Access Hospital with government local ownership, and the facility's cash price is notably lower than the Medicare benchmark of $8.62, which serves as the federal cost baseline for this procedure. When comparing to regional pricing standards, the facility's negotiated rates range from $30 to $100 across nine different payers, with the lowest allowed amount being $30 for Blue Cross Blue Shield and the highest reaching $100 for Medicaid/KanCare plans.
Patients should be aware that while insurance contracts often set a ceiling on charges, the cash price can sometimes be the most economical option, particularly for those with high-deductible plans where the insurer's negotiated rate might exceed the cash price. It is important to verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed. Since over 80% of hospital bills contain errors, consumers are advised to request an itemized billing audit before paying, ensuring that no unbundled codes or services not rendered are included in the final invoice. Additionally, because the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should not pay surprise bills immediately but instead should dispute any discrepancies with their insurer or the billing department.