CMS Price Transparency Data

Culture, bacterial

Facility: Adena Regional Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $30
  • Cash Discount Price: $24
  • vs. Medicare Baseline: 3.48x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Adena Regional Medical Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 3.48x the Medicare baseline. Located in 272 Hospital Road, Chillicothe, OH.
Cash / Self-Pay
$24

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $24 (278%)
Insurance Median: $30 (348%)
Cash: $24 (278% of Medicare)
Ins. Median: $30 (348% 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 348% of the Medicare baseline (a markup of 248%). 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 $9 - $63 104%
Buckeye Community Health Plan $9 104%
Care Source $9 104%
Gateway Health $9 104%
Humana $9 - $45 104%
Medical Mutual Of Ohio $9 - $31 104%
Medigold $9 104%
Molina $9 104%
UnitedHealthcare $9 - $21 104%
Molina Marketplace $14 162%
Care Source Just4Me $16 186%
Blue Cross Blue Shield $21 - $30 244%
Sidecar Health $24 278%
Cigna $29 336%
Ohio Ppo Connect $33 383%
The Health Plan $33 383%
First Health $37 - $62 429%
Ohio Health Choice $37 429%
Healthsmart $40 464%
Integrated Health Plan $45 522%
Multiplan/Private Healthcare Systems $45 522%
Three Rivers Network $45 522%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 272 Hospital Road, Chillicothe, OH 45601
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals