Culture, bacterial
Facility: Scott County Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $46
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 5.34x 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 534% of the Medicare baseline (a markup of 434%). 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 | $7 - $67 | 81% |
| Humana | $21 - $30 | 244% |
| Wppa | $31 - $1,200 | 360% |
| Blue Cross Blue Shield | $32 | 371% |
| Aetna | $46 - $64 | 534% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Scott County Hospital, the negotiated rates paid by insurance carriers range from $7 to $1,200, with a median negotiated amount of $46.00. This facility is a Critical Access Hospital in Scott City, Kansas, and its pricing is notably lower than the state average, which sits at $61.00. While the gross chargemaster price listed is $61.00, patients should be aware that commercial insurance contracts often include administrative overhead that can inflate the final allowed amount. If you have a high-deductible plan, paying the cash price directly might be more cost-effective than relying on insurance, as the negotiated rate could exceed the cash price once deductibles and copays are applied.
To minimize costs, we strongly recommend contacting the hospital before scheduling to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% for upfront payments. Additionally, if you receive an itemized bill, request a full line-by-line audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Finally, compare your facility's rates to the Medicare benchmark of $8.62; since commercial rates often average 200% to 300% of this federal baseline, the $46.00 median negotiated rate reflects a markup that is higher than the fair pricing range of 120% to 150% of Medicare, highlighting the importance of verifying your specific plan's allowed amount before treatment.