Culture, bacterial
Facility: Neosho Memorial Regional Medical Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $74
- Cash Discount Price: $165
- vs. Medicare Baseline: 8.58x 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 858% of the Medicare baseline (a markup of 758%). 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 |
|---|---|---|
| Medicaid / KanCare | $7 | 81% |
| Blue Cross Blue Shield | $35 - $74 | 406% |
| Tricare | $64 - $71 | 742% |
| Va_Ccn | $66 - $74 | 766% |
| Medadv_Allwell | $66 - $74 | 766% |
| Medicare (plans) | $66 - $74 | 766% |
| Aetna | $66 - $74 | 766% |
| Medadv_Uhc | $66 - $74 | 766% |
| Humana | $66 - $74 | 766% |
| Ambetter / Centene | $70 - $78 | 812% |
| Wppa_Providrscare | $172 - $192 | 1995% |
| United | $173 - $193 | 2007% |
| Hpk | $197 - $220 | 2285% |
| Coventry | $197 - $220 | 2285% |
| Cigna | $197 - $220 | 2285% |
Consumer Guidance & Cost Commentary
For the bacterial culture service (CPT 87070) at Neosho Memorial Regional Medical Center in Chanute, KS, the facility's cash median rate of $165.00 is notably higher than the state average of $144.00. While the facility is a Critical Access Hospital with government ownership, patients should be aware that commercial insurance negotiated rates for this service range widely, from $74.00 to $220.00, depending on the payer. For instance, Medicaid/KanCare plans pay a median of $7.00, whereas private payers like United and Hpk pay significantly higher amounts up to $220.00. Because commercial negotiated rates often include administrative overhead and vary by plan, a patient with a high deductible might find that paying the cash price directly is more cost-effective than relying on an insurance plan that has not yet met its deductible, especially given that some negotiated rates exceed the cash amount.
To minimize costs, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is also important to request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be disputed. Finally, while the facility's Medicare benchmark rate is $8.62, which serves as a baseline for fair pricing, commercial rates are often marked up significantly above this figure; however, the No Surprises Act protects patients from balance billing for out-of-network services at