Culture, bacterial
Facility: Amberwell Atchison Association
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $57
- Cash Discount Price: $119
- vs. Medicare Baseline: 6.61x 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 661% of the Medicare baseline (a markup of 561%). 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 |
|---|---|---|
| Triwest - All Plans | $28 - $57 | 325% |
| Superior Select Mcr Adv - All Plans | $28 - $57 | 325% |
| Humana | $28 - $78 | 325% |
| Va Ccn - All Plans | $28 - $57 | 325% |
| UnitedHealthcare | $28 - $310 | 325% |
| Blue Cross Blue Shield | $30 - $32 | 348% |
| Ambetter / Centene | $43 - $88 | 499% |
| Cigna | $47 - $95 | 545% |
| Aetna | $47 - $95 | 545% |
| Centrus Health Direct - All Plans | $64 - $130 | 742% |
| Oscar - All Plans | $64 - $130 | 742% |
| Multiplan - All Plans | $66 - $135 | 766% |
| Wppa Providrs Care - All Plans | $76 - $156 | 882% |
Consumer Guidance & Cost Commentary
For the bacterial culture service (CPT 87070), the cash price at Amberwell Atchison Association is $119.00, which matches the facility's median paid amount. This cash rate is significantly lower than the negotiated rates charged to commercial insurance plans, which range from $28 to $320 depending on the carrier. For instance, while UnitedHealthcare and Humana negotiate rates as high as $310 and $130 respectively, the cash price remains fixed at $119.00. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance negotiated rates often exceed the cash amount, potentially resulting in higher out-of-pocket costs if the patient's deductible has not yet been met.
To ensure you are receiving the most accurate pricing, it is recommended to request an itemized bill before finalizing payment, as summary bills can obscure individual charges and lead to errors. Additionally, you should inquire about "self-pay" or "prompt-pay" discounts, which can reduce the total amount owed by 20% to 50% if settled upfront. When evaluating the facility's pricing against broader benchmarks, the Medicare amount for this service is $8.62, providing a baseline for understanding the markup. The facility is located in Atchison, KS, and operates as a Critical Access Hospital, which often influences its pricing structure compared to larger regional centers.