Culture, bacterial
Facility: Girard Medical Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $54
- Cash Discount Price: $93
- vs. Medicare Baseline: 6.26x 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 626% of the Medicare baseline (a markup of 526%). 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 | $32 - $54 | 371% |
| Ambetter / Centene | $54 | 626% |
| Aetna | $54 - $271 | 626% |
| UnitedHealthcare | $54 - $147 | 626% |
| Kansas Superior Select-All Plans | $54 | 626% |
| Humana | $54 | 626% |
| Medicare (plans) | $54 | 626% |
| Multiplan-All Plans | $143 | 1659% |
| Uhhis-All Plans | $147 | 1705% |
Consumer Guidance & Cost Commentary
For the CPT code 87070 (Culture, bacterial) at Girard Medical Center in Kansas, the facility's cash median price is $93.00, which is notably higher than the state average of $63.00. While commercial insurance plans like Blue Cross Blue Shield and Ambetter / Centene have negotiated rates starting at $54.00, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying cash directly. It is important to note that while the facility is a Critical Access Hospital in Girard, KS, and owned by a Government Hospital District, the negotiated rates for in-network payers such as Aetna and UnitedHealthcare can vary significantly, ranging from $54.00 to $271.00 depending on the specific plan. Patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
To avoid unexpected costs, consumers should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. This bypasses the administrative overhead of insurance claims processing and often results in a lower final price than the standard cash rate. Additionally, if you receive a bill from an out-of-network provider or for services not covered by your plan, you may be subject to balance billing, where the provider charges the difference between their full chargemaster rate and what your insurance pays. Under the No Surprises Act, balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities, so any surprise bill should be disputed immediately with