CMS Price Transparency Data

Culture, bacterial

Facility: Rockcastle County Hospital, Inc.

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $101
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 11.72x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Rockcastle County Hospital, Inc. is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 11.72x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $94 (1090%)
Insurance Median: $101 (1172%)
Cash: $94 (1090% of Medicare)
Ins. Median: $101 (1172% 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 1172% of the Medicare baseline (a markup of 1072%). 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.

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
Tricare $6 70%
Blue Cross Blue Shield $7 - $119 81%
Caresource Mcr Adv-All Other Plans $9 104%
Humana $9 104%
Molina Marketplace - All Other Plans $9 104%
Molina Mcr Adv $9 104%
Signature Mcr Adv-All Plans $9 104%
Wellcare Mcr Adv-All Other Plans $9 104%
Passport Hp Hmo - All Plans $20 - $47 232%
Multiplan-All Plans $62 - $147 719%
Prime Health Services-All Plans $62 - $147 719%
Integrated Hp-All Plans $65 - $154 754%
Corvel - All Plans $66 - $156 766%
Center Care-All Plans $69 - $164 800%
Cigna $71 - $168 824%
Caresource Mcaid $73 - $173 847%
Coventry Mcaid-All Plans $73 - $173 847%
Medicaid / KanCare $73 - $173 847%
Molina Mcaid $73 - $173 847%
UnitedHealthcare $73 - $173 847%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals