CMS Price Transparency Data
Culture, bacterial
Facility: Mercy Hospital Springfield
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $116
- Cash Discount Price: $134
- vs. Medicare Baseline: 13.46x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercy Hospital Springfield is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 13.46x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$134
Average discount available for prompt cash payment at this facility.
Insurance Median
$116
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: $134 (1555%)
Insurance Median: $116 (1346%)
Cash: $134 (1555% of Medicare)
Ins. Median: $116 (1346% 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 1346% of the Medicare baseline (a markup of 1246%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $7 - $202 | 81% |
| Medicaid / KanCare | $7 - $17 | 81% |
| Aetna | $8 - $10 | 93% |
| Centurion Of Missouri [20459] | $8 | 93% |
| Champva [20065] | $8 | 93% |
| Cherokee Nation Health Serv Contracted [320066] | $8 | 93% |
| Cigna | $8 - $49 | 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 - $180 | 93% |
| Indian Health Service Contracted [320198] | $8 | 93% |
| Indian Health Service [20198] | $8 | 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% |
| Mercy Rehab Hospital Contracted [320260] | $8 | 93% |
| Pace Of The Ozarks Contracted [320518] | $8 | 93% |
| Qual Choice Contracted [320325] | $8 | 93% |
| Tricare | $8 | 93% |
| UnitedHealthcare | $8 - $203 | 93% |
| Provider Partners Health Plans Contracted [320450] | $9 | 104% |
| United Medical Resources Contracted [320454] | $9 - $137 | 104% |
| Healthscope Contracted [320182] | $11 | 128% |
| Centivo Contracted [320505] | $14 | 162% |
| Providrs Care Network Contracted [320484] | $16 | 186% |
| Aither Health Contracted [320449] | $17 - $150 | 197% |
| Ambetter / Centene | $17 | 197% |
| Auxiant Contracted [320462] | $17 - $172 | 197% |
| Ebms Contracted [320493] | $17 | 197% |
| Healthlink Contracted [320179] | $17 - $52 | 197% |
| Home State Health Plan Contracted [320187] | $17 | 197% |
| Imagine 360 Contracted [320494] | $17 | 197% |
| Mercy Benefit Admin Contracted [320251] | $17 - $150 | 197% |
| Novasys Contracted [320285] | $17 | 197% |
| Reflect Health Contracted [320492] | $17 | 197% |
| Yuzu Health Contracted [320521] | $17 | 197% |
| 90 Degree Benefits Contracted [320436] | $50 | 580% |
| Benefit Management Contracted [320052] | $50 - $106 | 580% |
| Health Systems Inc Contracted [320174] | $50 - $106 | 580% |
| Insurance System Inc Contracted [320465] | $50 - $106 | 580% |
| Show-Me Health Administrators Contracted [320483] | $50 - $53 | 580% |
| Administrative Payor Contracted [320005] | $56 - $132 | 650% |
| Evolutions Health Care Contracted [320124] | $56 - $119 | 650% |
| Point C Contracted [320238] | $56 - $198 | 650% |
| Point C [20238] | $56 - $119 | 650% |
| Medical Destinations Contracted [320242] | $62 - $132 | 719% |
| Workers Comp [20426] | $62 - $224 | 719% |
| First Health Contracted [320128] | $69 - $148 | 800% |
| Edison Health Solutions Contracted [320502] | $71 - $150 | 824% |
| Federal Medical Center Contracted [320127] | $74 - $158 | 858% |
| Multiplan Contracted [320270] | $95 - $203 | 1102% |
| Private Health Care Systems Contracted [320320] | $95 - $203 | 1102% |
| Compcare Of The Ozarks Contracted [320437] | $98 - $209 | 1137% |
| American Healthcare Alliance Contracted [320020] | $99 - $211 | 1148% |
| Qual Choice Contracted [320324] | $99 - $211 | 1148% |
| Municipal Health Plan Contracted [320271] | $100 - $214 | 1160% |
| Usa Managed Care Org Contracted [320429] | $109 - $232 | 1265% |
| Ppo Plus Contracted [320310] | $112 - $238 | 1299% |