CMS Price Transparency Data

Culture, bacterial

Facility: Pawnee County Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $110
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 12.76x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Pawnee County Memorial Hospital is $110. 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 12.76x the Medicare baseline. Located in 600 I Street, Pawnee City, NE.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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: $110 (1276%)
Cash: $94 (1090% of Medicare)
Ins. Median: $110 (1276% 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 1276% of the Medicare baseline (a markup of 1176%). 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 $81 - $111 940%
Blue Cross Blue Shield $81 - $112 940%
Medica Choice $81 - $107 940%
UnitedHealthcare $81 - $112 940%
Ambetter / Centene $110 1276%
Medica Ifb $113 1311%
Midlands Choice $113 1311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 I Street, Pawnee City, NE 68420
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals