CMS Price Transparency Data

Culture, bacterial

Facility: Mercy Hospital Southeast

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $43
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 4.99x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercy Hospital Southeast is $43. 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 4.99x the Medicare baseline. Located in 1701 Lacey St, Cape Girardeau, MO.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $43 (499%)
Cash: $94 (1090% of Medicare)
Ins. Median: $43 (499% 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 499% of the Medicare baseline (a markup of 399%). 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
Aetna $2 - $177 23%
Medicaid / KanCare $2 - $42 23%
Blue Cross Blue Shield $8 - $263 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%
Halo Hcr Inc Hospice Contracted [320432] $8 93%
Halo Hcr Inc Hospice [20432] $8 93%
Humana $8 - $235 93%
Kindful Hospice Contracted [320434] $8 93%
Kindful Hospice [20434] $8 93%
Medicare (plans) $8 - $9 93%
Mercy Hospice Okc [20252] $8 93%
Pace Of The Ozarks Contracted [320518] $8 93%
Tricare $8 93%
UnitedHealthcare $8 - $21 93%
American Health Advantage Of Mo Mcr Hmo Contracted [320264] $9 104%
Provider Partners Health Plans Contracted [320450] $10 116%
United Medical Resources Contracted [320454] $10 116%
Ambetter / Centene $11 128%
Home State Health Plan Contracted [320187] $11 128%
Consociate Consolidated Health Contracted [320490] $12 - $19 139%
Auxiant Contracted [320462] $14 - $17 162%
Centivo Contracted [320505] $14 162%
Ebms Contracted [320493] $14 162%
Healthlink Contracted [320179] $14 - $216 162%
Imagine 360 Contracted [320494] $14 162%
Mercy Benefit Admin Contracted [320251] $14 - $188 162%
Yuzu Health Contracted [320521] $14 - $188 162%
Preferred Health Plan Contracted [320522] $15 174%
Reflect Health Contracted [320492] $15 174%
First Health Contracted [320128] $19 - $177 220%
Aither Health Contracted [320449] $20 - $188 232%
Edison Health Solutions Contracted [320502] $20 - $188 232%
Health Alliance Contracted [320164] $20 - $180 232%
Mercy Benefit Admin [20251] $20 - $188 232%
Hope Trust Contracted [320488] $21 244%
Workers Comp [20426] $22 - $222 255%
Cigna $23 267%
Multiplan Contracted [320270] $24 - $222 278%
Private Health Care Systems Contracted [320320] $24 - $222 278%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Lacey St, Cape Girardeau, MO 63701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals