Culture, bacterial
Facility: Kingman Healthcare Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $6
- Cash Discount Price: $6
- vs. Medicare Baseline: 0.70x 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.
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 | $3 - $62 | 35% |
| Ambetter / Centene | $3 - $30 | 35% |
| Wellcare | $3 - $27 | 35% |
| Humana | $3 - $27 | 35% |
| Celtic Insurance Company | $3 - $30 | 35% |
| Medicaid / KanCare | $3 - $30 | 35% |
| Health Partners | $6 - $62 | 70% |
| Cigna | $6 - $62 | 70% |
| Aetna | $6 - $62 | 70% |
| Healthy Blue | $7 | 81% |
| Triwest | $9 | 104% |
Consumer Guidance & Cost Commentary
For the CPT code 87070 (Culture, bacterial) at Kingman Healthcare Center in Kansas, the facility's cash median rate of $6.00 is significantly lower than the gross charge of $12.00 and represents a substantial discount compared to the Medicare benchmark of $8.62. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. In this case, the lowest negotiated rates observed across payers like UnitedHealthcare and Cigna range from $3.00 to $6.00, which aligns with the cash median but may still be higher than the actual cash price for those with high-deductible plans. Because the cash rate is lower than the Medicare benchmark, paying out-of-pocket could result in immediate savings, provided the patient has not met their insurance deductible and has verified the specific allowed amount with their carrier.
To maximize cost savings, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling services, as these upfront fee reductions can bypass the costly insurance claims cycle and administrative processing fees. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected ancillary charges or errors in itemized billing can still occur. If a patient receives a bill, they should request a full itemized statement to review specific CPT codes and identify any unbundled charges or services not rendered, as over 80% of hospital bills contain errors. Disputing these errors in writing with the billing supervisor is the most effective way to reduce