CMS Price Transparency Data

Culture, bacterial

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $26
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 3.02x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Munson Healthcare Otsego Memorial Hospital is $26. 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 3.02x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $26 (302%)
Cash: $94 (1090% of Medicare)
Ins. Median: $26 (302% 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 302% of the Medicare baseline (a markup of 202%). 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
UnitedHealthcare $3 - $89 35%
Blue Cross Blue Shield $5 - $69 58%
Mclaren Health Plan $5 - $93 58%
Meridian $5 58%
Molina $5 - $9 58%
Priority Health $5 - $37 58%
Aetna $7 - $90 81%
Blue Care Network $9 104%
Cigna $9 - $37 104%
Hap (Health Alliance Plan) $9 - $89 104%
Humana $9 104%
Medicare (plans) $9 104%
Michigan Amish Medical Board $9 104%
Northern Michigan Mennonite Group $9 104%
Employee Benefit Logistics $15 174%
Hospice Of Michigan $67 777%
Munson Hospice $78 - $852 905%
Asr Physicians Care Network $89 1032%
Enterprise Group Planning/Employee Benefit Plan $89 1032%
Nomi Health $89 1032%
Cofinity $94 - $100 1090%
Provider Network Of America/Hawaii Mainland Administrative Group Health $94 1090%
Three Rivers Provider Network $94 1090%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 825 N Center Ave, Gaylord, MI 49735
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals