CMS Price Transparency Data

Culture, bacterial

Facility: The Children's Mercy Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $69
Cash Discount Price: $50
vs. Medicare Baseline: 8.00x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at The Children's Mercy Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 8.00x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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: $50 (580%)

Insurance Median: $69 (800%)

Cash: $50 (580% of Medicare)

Ins. Median: $69 (800% 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 800% of the Medicare baseline (a markup of 700%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Healthy Blue	$8 - $24	93%
UnitedHealthcare	$8 - $414	93%
Medicaid / KanCare	$9	104%
Home State Health	$21	244%
Blue Cross Blue Shield	$32 - $456	371%
Cigna	$37 - $428	429%
Medica	$45 - $359	522%
Aetna	$47 - $419	545%
Centivo	$51 - $400	592%
Health Midwest Comprehensive Care	$51 - $401	592%
Nebraska Furniture Mart	$51 - $400	592%
Orscheln	$51 - $400	592%
Quiktrip	$51 - $401	592%
Wellfit/Centrus	$51 - $400	592%
Wppa Providrs Care	$51 - $400	592%
Humana	$52 - $410	603%
Coventry Health Care Of Kansas	$58 - $456	673%
Coxhealth Network	$58 - $456	673%
Mercy Health	$58 - $462	673%
Multiplan	$59 - $468	684%
American Healthcare Alliance	$66 - $524	766%
Healthlink	$69 - $542	800%
National Preferred Provider Network	$70 - $554	812%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $50.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87070.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Children's Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87070.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.