CMS Price Transparency Data

Culture, bacterial

Facility: T J Samson Community Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $27
Cash Discount Price: $24
vs. Medicare Baseline: 3.13x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at T J Samson Community Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 3.13x the Medicare baseline. Located in 1301 North Race Street, Glasgow, KY.

Cash / Self-Pay

$24

Average discount available for prompt cash payment at this facility.

Insurance Median

$27

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.62

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.62 (100%)

Cash / Self-Pay: $24 (278%)

Insurance Median: $27 (313%)

Cash: $24 (278% of Medicare)

Ins. Median: $27 (313% of 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 313% of the Medicare baseline (a markup of 213%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Caresource - All Plans	$3 - $11	35%
Blue Cross Blue Shield	$7 - $107	81%
Wellcare Mcaid	$8	93%
Devoted Mcr Adv - All Plans	$9	104%
Humana	$9 - $126	104%
Molina Mcr Adv	$9	104%
Signature Health - All Plans	$9	104%
Wellcare Mcr Adv - All Other Plans	$9	104%
Molina Marketplace - All Other Plans	$13	151%
UnitedHealthcare	$15 - $63	174%
Center Care Select - All Plans	$26 - $107	302%
First Health - All Plans	$28 - $120	325%
Phcs/Multiplan - All Plans	$28 - $118	325%
Aetna	$30 - $126	348%
Molina Mcaid	$31 - $130	360%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $24.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87070.

Insurance In-Network Protection Plan

Contact your insurance company to confirm T J Samson Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87070.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.