CMS Price Transparency Data
Culture, bacterial
Facility: Mercy Hospital - Cassville
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $136
- Cash Discount Price: $112
- vs. Medicare Baseline: 15.78x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercy Hospital - Cassville is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 15.78x the Medicare baseline. Located in 94 Main Street, Cassville, MO.
Cash / Self-Pay
$112
Average discount available for prompt cash payment at this facility.
Insurance Median
$136
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: $112 (1299%)
Insurance Median: $136 (1578%)
Cash: $112 (1299% of Medicare)
Ins. Median: $136 (1578% 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 1578% of the Medicare baseline (a markup of 1478%). 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 - $99 | 81% |
| Aetna | $8 - $170 | 93% |
| Humana | $8 - $162 | 93% |
| Blue Cross Blue Shield | $9 - $185 | 104% |
| Medicare (plans) | $9 - $82 | 104% |
| UnitedHealthcare | $12 - $181 | 139% |
| Dept Of Veteran Affairs Contracted [320106] | $53 - $65 | 615% |
| Tricare | $63 - $77 | 731% |
| Cherokee Nation Health Serv Contracted [320066] | $64 - $79 | 742% |
| Cigna | $64 - $181 | 742% |
| Cross Timbers Hospice [20098] | $64 - $79 | 742% |
| Elara Caring Aspire Hospice [20433] | $64 - $79 | 742% |
| Globalhealth Contracted [320145] | $64 - $79 | 742% |
| Halo Hcr Inc Hospice Contracted [320432] | $64 - $79 | 742% |
| Halo Hcr Inc Hospice [20432] | $64 - $79 | 742% |
| Indian Health Service Contracted [320198] | $64 - $79 | 742% |
| Kindful Hospice Contracted [320434] | $64 - $79 | 742% |
| Kindful Hospice [20434] | $64 - $79 | 742% |
| Medical Associates Health Contracted [320444] | $64 - $79 | 742% |
| Mercy Hospice Okc [20252] | $64 - $79 | 742% |
| Mercy Mgd Behavioral Health Contracted [320259] | $64 - $79 | 742% |
| Pace Of The Ozarks Contracted [320518] | $64 - $79 | 742% |
| Provider Partners Health Plans Contracted [320450] | $64 - $79 | 742% |
| Qual Choice Contracted [320325] | $64 - $79 | 742% |
| Healthscope Contracted [320182] | $65 - $80 | 754% |
| Administrative Payor Contracted [320005] | $70 - $86 | 812% |
| Centivo Contracted [320505] | $79 - $97 | 916% |
| Ambetter / Centene | $81 - $99 | 940% |
| Home State Health Plan Contracted [320187] | $81 - $99 | 940% |
| Novasys Contracted [320285] | $81 - $99 | 940% |
| Healthlink Contracted [320179] | $101 - $172 | 1172% |
| Preferred Health Plan Contracted [320522] | $101 - $124 | 1172% |
| Health Systems Inc Contracted [320174] | $124 - $153 | 1439% |
| Insurance System Inc Contracted [320465] | $124 - $153 | 1439% |
| Point C Contracted [320238] | $124 - $172 | 1439% |
| Point C [20238] | $124 - $153 | 1439% |
| United Medical Resources Contracted [320454] | $124 - $162 | 1439% |
| Workers Comp [20426] | $124 - $172 | 1439% |
| Municipal Health Plan Contracted [320271] | $126 - $155 | 1462% |
| Medica Contracted [320239] | $139 - $171 | 1613% |
| 90 Degree Benefits Contracted [320436] | $140 - $172 | 1624% |
| Aither Health Contracted [320449] | $140 - $172 | 1624% |
| American Healthcare Alliance Contracted [320020] | $140 - $172 | 1624% |
| Auxiant Contracted [320462] | $140 - $172 | 1624% |
| Benefit Management Contracted [320052] | $140 - $172 | 1624% |
| Ebms Contracted [320493] | $140 - $172 | 1624% |
| Edison Health Solutions Contracted [320502] | $140 - $172 | 1624% |
| Evolutions Health Care Contracted [320124] | $140 - $172 | 1624% |
| Imagine 360 Contracted [320494] | $140 - $172 | 1624% |
| Mercy Benefit Admin Contracted [320251] | $140 - $172 | 1624% |
| Reflect Health Contracted [320492] | $140 - $172 | 1624% |
| Show-Me Health Administrators Contracted [320483] | $140 - $172 | 1624% |
| Usa Managed Care Org Contracted [320429] | $140 - $172 | 1624% |
| Yuzu Health Contracted [320521] | $140 - $172 | 1624% |
| First Health Contracted [320128] | $147 - $181 | 1705% |
| Multiplan Contracted [320270] | $147 - $181 | 1705% |
| Private Health Care Systems Contracted [320320] | $147 - $181 | 1705% |