CMS Price Transparency Data
Culture, bacterial
Facility: Mercy Health Lakeshore Campus
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $71
- Cash Discount Price: $54
- vs. Medicare Baseline: 8.24x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercy Health Lakeshore Campus is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 8.24x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$54
Average discount available for prompt cash payment at this facility.
Insurance Median
$71
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: $54 (626%)
Insurance Median: $71 (824%)
Cash: $54 (626% of Medicare)
Ins. Median: $71 (824% 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 824% of the Medicare baseline (a markup of 724%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $6 - $74 | 70% |
| Medicaid / KanCare | $6 | 70% |
| Blue Care Network Advantage | $8 | 93% |
| Medicare (plans) | $8 - $21 | 93% |
| U Of M Health Plan | $10 - $77 | 116% |
| Wellpath | $13 | 151% |
| Access Health | $14 - $15 | 162% |
| Aetna | $20 - $68 | 232% |
| Align Senior Care | $20 - $22 | 232% |
| Correctional Recovery | $20 - $22 | 232% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $22 - $24 | 255% |
| Oscar | $24 - $26 | 278% |
| Vitalcore | $26 - $29 | 302% |
| UnitedHealthcare | $28 - $77 | 325% |
| Molina Marketplace | $33 - $36 | 383% |
| Hospice Of Michigan | $43 - $47 | 499% |
| Nomi Health | $44 - $48 | 510% |
| Hap | $59 - $77 | 684% |
| Wc Accident Fund | $62 - $68 | 719% |
| Wc Advantage | $62 - $68 | 719% |
| Wc Aig | $62 - $68 | 719% |
| Wc Allied | $62 - $68 | 719% |
| Wc Amerisure | $62 - $68 | 719% |
| Wc Amtrust | $62 - $68 | 719% |
| Wc Asu Risk Mgt | $62 - $68 | 719% |
| Wc Berkley Admin | $62 - $68 | 719% |
| Wc Broadspire | $62 - $68 | 719% |
| Wc Bunch & Associates | $62 - $68 | 719% |
| Wc Ccmsi | $62 - $68 | 719% |
| Wc Emc Insurance Company | $62 - $68 | 719% |
| Wc Esis | $62 - $68 | 719% |
| Wc Fcci | $62 - $68 | 719% |
| Wc Federated | $62 - $68 | 719% |
| Wc Gallagher Bassett | $62 - $68 | 719% |
| Wc Genex Care For Ohio | $62 - $68 | 719% |
| Wc Guard Insurance Company | $62 - $68 | 719% |
| Wc Hartford | $62 - $68 | 719% |
| Wc Liberty Mutual | $62 - $68 | 719% |
| Wc Meijers | $62 - $68 | 719% |
| Wc Michigan | $62 - $68 | 719% |
| Wc Mitchell Frankenmuth | $62 - $68 | 719% |
| Wc Pma | $62 - $68 | 719% |
| Wc Sedgwick | $62 - $68 | 719% |
| Wc Sentry | $62 - $68 | 719% |
| Wc Travelers | $62 - $68 | 719% |
| Wc Tristar | $62 - $68 | 719% |
| Wc Walmart | $62 - $68 | 719% |
| Wc Zurich | $62 - $68 | 719% |
| Geha | $63 - $77 | 731% |
| Meritain | $63 - $68 | 731% |
| Asr Health Benefits | $66 - $72 | 766% |
| 1199 National Benefit Fund | $68 - $74 | 789% |
| Allied National Global Care | $68 - $74 | 789% |
| Asrm - Reliance Standard Life Insurance | $68 - $74 | 789% |
| Bcn Domestic | $68 - $74 | 789% |
| Blue Benefit Administrators Of Massachusetts | $68 - $74 | 789% |
| Blue Care Network | $68 - $74 | 789% |
| Blue Distinction Transplant | $68 - $74 | 789% |
| Blue Shield - Ca | $68 - $74 | 789% |
| Blue Shield - Id (Regence) | $68 - $74 | 789% |
| Blue Shield - Ny Highmark Northeastern | $68 - $74 | 789% |
| Blue Shield - Ny Highmark Western | $68 - $74 | 789% |
| Blue Shield - Pa (Highmark) | $68 - $74 | 789% |
| Blue Shield - Wa (Regence) | $68 - $74 | 789% |
| Christian Care Ministry | $68 - $74 | 789% |
| Dean Health | $68 - $74 | 789% |
| Fallon Health | $68 - $74 | 789% |
| Family Life Insurance Company | $68 - $74 | 789% |
| Ghc Scw | $68 - $74 | 789% |
| Group Pension Administrators | $68 - $74 | 789% |
| Health Choices | $68 - $77 | 789% |
| International Benefit Administrators | $68 - $74 | 789% |
| Kaiser Domestic | $68 - $74 | 789% |
| Lifetime Benefit Solutions | $68 - $74 | 789% |
| Manhattan Life | $68 - $74 | 789% |
| Medi Share | $68 - $74 | 789% |
| Multiplan | $68 - $74 | 789% |
| Mvp | $68 - $74 | 789% |
| Pai | $68 - $74 | 789% |
| Pan-American Life | $68 - $74 | 789% |
| Paramount Hmo | $68 - $74 | 789% |
| Phcs | $68 - $74 | 789% |
| Trinity Health Share | $68 - $74 | 789% |
| Cigna | $69 - $75 | 800% |
| Caresource | $70 - $77 | 812% |
| Acclaim | $71 - $77 | 824% |
| Administrative Concepts | $71 - $77 | 824% |
| Allegeant | $71 - $77 | 824% |
| Allied Benefit Systems | $71 - $77 | 824% |
| Ameriben | $71 - $77 | 824% |
| American Family | $71 - $77 | 824% |
| American Healthcare Alliance | $71 - $77 | 824% |
| American Republic | $71 - $77 | 824% |
| Amerihealth | $71 - $77 | 824% |
| Aultcare | $71 - $77 | 824% |
| Automated Benefit Services | $71 - $77 | 824% |
| Auxiant | $71 - $77 | 824% |
| Benefit Administrative Systems,Llc | $71 - $77 | 824% |
| Boon Chapman | $71 - $77 | 824% |
| Cam Administrative Services | $71 - $77 | 824% |
| Christian Brother Services | $71 - $77 | 824% |
| Christian Brothers Holy Cross | $71 - $77 | 824% |
| Claimchoice Adminstrators | $71 - $77 | 824% |
| Comprehensive Benefits | $71 - $77 | 824% |
| Consociate | $71 - $77 | 824% |
| Continental Life Insurance | $71 - $77 | 824% |
| Custom Benefit Administrators | $71 - $77 | 824% |
| Cypress Benefit Administrators | $71 - $77 | 824% |
| Employee Benefit Concepts | $71 - $77 | 824% |
| Employee Benefit Management | $71 - $77 | 824% |
| Enterprise Group Planning | $71 - $77 | 824% |
| First Health | $71 - $78 | 824% |
| Forest County Potawatomi | $71 - $77 | 824% |
| Freedom Life Insurance Company | $71 - $77 | 824% |
| Group Administrators | $71 - $77 | 824% |
| Group Marketing Services | $71 - $77 | 824% |
| Guardian | $71 - $77 | 824% |
| Health America | $71 - $77 | 824% |
| Health Smart | $71 - $77 | 824% |
| Healthez | $71 - $77 | 824% |
| Healthgram | $71 - $77 | 824% |
| Healthscope | $71 - $77 | 824% |
| Humana | $71 - $77 | 824% |
| Insight | $71 - $77 | 824% |
| Intercare | $71 - $77 | 824% |
| Jfp Benefit Management | $71 - $77 | 824% |
| Jp Farley Corporation | $71 - $77 | 824% |
| Key Benefit Administrator | $71 - $77 | 824% |
| Liberty Union Life Assurance Co | $71 - $77 | 824% |
| Lucent Health | $71 - $77 | 824% |
| Luminare Health | $71 - $77 | 824% |
| Luminare Health (Detroit) | $71 - $77 | 824% |
| Medben | $71 - $77 | 824% |
| Medcost | $71 - $77 | 824% |
| Medical Mutual | $71 - $77 | 824% |
| Mutual Health Services | $71 - $77 | 824% |
| Mutual Of Omaha | $71 - $77 | 824% |
| Ncas | $71 - $77 | 824% |
| Nippon Life Ins | $71 - $77 | 824% |
| Nova | $71 - $77 | 824% |
| Painters Union Insurance Fund | $71 - $77 | 824% |
| Physicians Mutual | $71 - $77 | 824% |
| Plumbers Local 98 Insurance Fund | $71 - $77 | 824% |
| Prairie States | $71 - $77 | 824% |
| Primary Physician Care | $71 - $77 | 824% |
| Priority Health | $71 - $78 | 824% |
| Professional Benefit Administrators | $71 - $77 | 824% |
| Secureone Preferred United Plans | $71 - $77 | 824% |
| The Loomis Company | $71 - $77 | 824% |
| Trustmark Small Business Benefits | $71 - $77 | 824% |
| Unicare | $71 - $77 | 824% |
| Unified Group Services | $71 - $77 | 824% |
| Us Health And Life | $71 - $77 | 824% |
| Valenz | $71 - $77 | 824% |
| Varipro | $71 - $77 | 824% |
| Western & Southern Financial Group | $71 - $77 | 824% |
| Wps | $71 - $77 | 824% |