CMS Price Transparency Data

Culture, bacterial

Facility: Mercy Hospital Lebanon

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $128
  • Cash Discount Price: $111
  • vs. Medicare Baseline: 14.85x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercy Hospital Lebanon is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 14.85x the Medicare baseline. Located in 100 Hospital Drive, Lebanon, MO.
Cash / Self-Pay
$111

Average discount available for prompt cash payment at this facility.

Insurance Median
$128

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: $111 (1288%)
Insurance Median: $128 (1485%)
Cash: $111 (1288% of Medicare)
Ins. Median: $128 (1485% 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 1485% of the Medicare baseline (a markup of 1385%). 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 $7 - $18 81%
Aetna $8 - $128 93%
Blue Cross Blue Shield $8 - $84 93%
Champva [20065] $8 93%
Cherokee Nation Health Serv Contracted [320066] $8 93%
Cigna $8 - $127 93%
Cross Timbers Hospice [20098] $8 93%
Dept Of Veteran Affairs Contracted [320106] $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 - $145 93%
Kindful Hospice Contracted [320434] $8 93%
Kindful Hospice [20434] $8 93%
Medica Contracted [320239] $8 93%
Medica [20239] $8 93%
Medicare (plans) $8 - $9 93%
Mercy Hospice Okc [20252] $8 93%
Mercy Mgd Behavioral Health Contracted [320259] $8 93%
Pace Of The Ozarks Contracted [320518] $8 93%
Provider Partners Health Plans Contracted [320450] $8 93%
Qual Choice Contracted [320325] $8 93%
Tricare $8 93%
UnitedHealthcare $8 - $162 93%
Healthscope Contracted [320182] $11 128%
United Medical Resources Contracted [320454] $11 - $137 128%
Centivo Contracted [320505] $14 162%
Ambetter / Centene $18 209%
Home State Health Plan Contracted [320187] $18 209%
Novasys Contracted [320285] $18 209%
Administrative Payor Contracted [320005] $77 893%
Healthlink Contracted [320179] $111 - $145 1288%
Preferred Health Plan Contracted [320522] $111 1288%
90 Degree Benefits Contracted [320436] $128 1485%
Mercy Benefit Admin Contracted [320251] $128 - $137 1485%
Show-Me Health Administrators Contracted [320483] $128 1485%
Aither Health Contracted [320449] $137 1589%
Auxiant Contracted [320462] $137 1589%
Benefit Management Contracted [320052] $137 1589%
Ebms Contracted [320493] $137 1589%
Edison Health Solutions Contracted [320502] $137 1589%
Evolutions Health Care Contracted [320124] $137 1589%
First Health Contracted [320128] $137 1589%
Health Systems Inc Contracted [320174] $137 1589%
Imagine 360 Contracted [320494] $137 1589%
Insurance System Inc Contracted [320465] $137 1589%
Point C Contracted [320238] $137 - $162 1589%
Point C [20238] $137 1589%
Reflect Health Contracted [320492] $137 1589%
Workers Comp [20426] $137 - $145 1589%
Yuzu Health Contracted [320521] $137 1589%
American Healthcare Alliance Contracted [320020] $145 1682%
Usa Managed Care Org Contracted [320429] $150 1740%
Multiplan Contracted [320270] $162 1879%
Private Health Care Systems Contracted [320320] $162 1879%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Hospital Drive, Lebanon, MO 65536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals