CMS Price Transparency Data

Culture, bacterial

Facility: Mercy Hospital Jefferson

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $90
  • Cash Discount Price: $123
  • vs. Medicare Baseline: 10.44x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercy Hospital Jefferson is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 10.44x the Medicare baseline. Located in 1400 Us Highway 61, Crystal City, MO.
Cash / Self-Pay
$123

Average discount available for prompt cash payment at this facility.

Insurance Median
$90

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: $123 (1427%)
Insurance Median: $90 (1044%)
Cash: $123 (1427% of Medicare)
Ins. Median: $90 (1044% 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 1044% of the Medicare baseline (a markup of 944%). 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
Medicaid / KanCare $4 - $35 46%
Aetna $8 - $58 93%
American Health Advantage Of Mo Mcr [10473] $8 93%
Blue Cross Blue Shield $8 - $210 93%
Cherokee Nation Health Serv Contracted [320066] $8 93%
Cross Timbers Hospice [20098] $8 93%
Dept Of Veteran Affairs Contracted [320106] $8 93%
Elara Caring Aspire Hospice Contracted [320433] $8 93%
Elara Caring Aspire Hospice [20433] $8 93%
Globalhealth Contracted [320145] $8 93%
Halo Hcr Inc Hospice Contracted [320432] $8 93%
Halo Hcr Inc Hospice [20432] $8 93%
Humana $8 93%
Kindful Hospice Contracted [320434] $8 93%
Kindful Hospice [20434] $8 93%
Medicare (plans) $8 - $233 93%
Mercy Hospice Okc [20252] $8 93%
Pace Of The Ozarks Contracted [320518] $8 93%
Qual Choice Contracted [320325] $8 93%
Tricare $8 93%
UnitedHealthcare $8 - $10 93%
Cigna $9 - $105 104%
Provider Partners Health Plans Contracted [320450] $9 104%
United Medical Resources Contracted [320454] $10 116%
Aither Health Contracted [320449] $11 128%
Aither Health [20449] $11 128%
Auxiant Contracted [320462] $11 128%
Ebms Contracted [320493] $11 128%
Edison Health Solutions Contracted [320502] $11 128%
Healthlink Contracted [320179] $11 - $158 128%
Healthscope Contracted [320182] $11 128%
Imagine 360 Contracted [320494] $11 128%
Mercy Benefit Admin Contracted [320251] $11 - $15 128%
Mercy Benefit Admin [20251] $11 - $15 128%
Reflect Health Contracted [320492] $11 128%
Show-Me Health Administrators Contracted [320483] $11 128%
Yuzu Health Contracted [320521] $11 128%
Medica Contracted [320239] $12 139%
Ambetter / Centene $14 162%
Centivo Contracted [320505] $14 162%
Home State Health Plan Contracted [320187] $14 162%
Novasys Contracted [320285] $14 162%
Preferred Health Plan Contracted [320522] $15 174%
Hope Trust Contracted [320488] $19 220%
Health Choices Contracted [320448] $35 - $140 406%
Health Choices [20448] $35 - $140 406%
Medical Associates Health Contracted [320444] $35 - $140 406%
Federal Medical Center Contracted [320127] $38 - $151 441%
Insurance System Inc Contracted [320465] $38 - $151 441%
Point C Contracted [320238] $38 - $151 441%
Tri State Healthcare Coalition Contracted [320379] $38 - $151 441%
First Health Contracted [320128] $41 - $165 476%
Mercy Mgd Behavioral Health Contracted [320259] $41 - $163 476%
Multiplan Contracted [320270] $41 - $175 476%
Private Health Care Systems Contracted [320320] $41 - $163 476%
Workers Comp [20426] $44 - $186 510%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 Us Highway 61, Crystal City, MO 63019
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals