CMS Price Transparency Data

Culture, bacterial

Facility: Daniels Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $100
Cash Discount Price: $112
vs. Medicare Baseline: 11.60x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Daniels Memorial Hospital is $100. 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 11.60x the Medicare baseline. Located in 105 5Th Ave E, Scobey, MT.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $100 (1160%)

Cash: $112 (1299% of Medicare)

Ins. Median: $100 (1160% 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 1160% of the Medicare baseline (a markup of 1060%). 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
Allegiance Mcr	$56 - $122	650%
Triwest Ccn-All Plans	$56 - $122	650%
Geha - All Plans	$77 - $168	893%
Montana Health Co-Op Hpn	$79 - $173	916%
Blue Cross Blue Shield	$81 - $177	940%
UnitedHealthcare	$87 - $191	1009%
Allegiance Comml-All Other Plans	$88 - $193	1021%
Montana Health Co-Op-All Other Plans	$88 - $193	1021%
Pacific Source Comml-All Plans	$88 - $193	1021%
Interwest Ppo - All Plans	$90 - $197	1044%

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 $112.
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 Daniels Memorial 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.