Culture, bacterial
Facility: Mitchell County Hospital Health Systems
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $107
- Cash Discount Price: $102
- vs. Medicare Baseline: 12.41x 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 1241% of the Medicare baseline (a markup of 1141%). 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 | $9 - $113 | 104% |
| Blue Cross Blue Shield | $32 | 371% |
| Triwest Well Mark All Plans | $96 | 1114% |
| First Health-All Plans | $102 | 1183% |
| Pref Hlth Care Sytms Comm - All Plans | $102 | 1183% |
| Aetna | $102 | 1183% |
| Auxiant-All Plans | $107 | 1241% |
| Multiplan Ppo - All Plans | $107 | 1241% |
| Phc Leased Ntwrk Access - All Plans | $107 | 1241% |
| Cigna | $112 | 1299% |
| Health Partners Ks-All Plans | $112 | 1299% |
Consumer Guidance & Cost Commentary
For the CPT code 87070 (Culture, bacterial) at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash price of $102.00 is lower than the median negotiated rate of $107.00 paid by most insurance plans. While the facility is a Critical Access Hospital with government local ownership, patients should note that commercial insurance contracts often result in higher out-of-pocket costs due to administrative overhead and multi-layered pricing structures. If you have a high-deductible plan, paying the cash price of $102.00 upfront may save you money compared to your insurance's negotiated rate of $107.00, provided you have not yet met your deductible. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these can further reduce the final amount owed.
When evaluating this charge, it is important to compare rates against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this service is $8.62, which serves as the objective baseline for fair pricing; commercial negotiated rates typically range from 120% to 150% of this figure, though the data shows a variance of 12.4% above the Medicare rate for this specific transaction. Patients should be aware of balance billing risks, particularly if receiving out-of-network ancillary services like emergency lab work, which could trigger unexpected bills despite being at an in-network facility. To avoid errors, always request a detailed, itemized bill that lists specific CPT codes, as summary invoices often obscure unbundled charges or services not rendered.