Culture, bacterial
Facility: Morris County Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $80
- Cash Discount Price: $124
- vs. Medicare Baseline: 9.28x 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 928% of the Medicare baseline (a markup of 828%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $9 | 104% |
| Va Ccn-All Plans | $18 | 209% |
| Aetna | $18 | 209% |
| Blue Cross Blue Shield | $30 - $80 | 348% |
| UnitedHealthcare | $80 - $206 | 928% |
| Coventry Mcr | $80 | 928% |
| Choice Care Mcr Adv-All Plans | $80 | 928% |
| Cigna | $149 | 1729% |
| Multiplan-All Plans | $185 | 2146% |
| Coventry Comm-All Other Plans | $185 | 2146% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Morris County Hospital in Council Grove, KS, the cash price of $124.00 is significantly lower than the negotiated rates paid by most major insurance carriers, which range from $80.00 to $206.00. While the facility's cash rate is higher than the state average of $79.00, it remains well below the gross chargemaster price of $206.00. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates for many payers exceed the cash amount. To secure the lowest possible rate, it is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final bill.
The facility's pricing is benchmarked against Medicare, which sets a baseline rate of $8.62 for this procedure. Although the commercial negotiated rates are higher than the Medicare amount, they are generally aligned with the facility's historical performance, with a median negotiated rate of $80.00. 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, patients should still request an itemized bill to ensure no unbundled charges or services not rendered are included. If a discrepancy arises, a formal written audit dispute should be sent to the billing supervisor rather than accepting a summary bill or settling verbally.