CMS Price Transparency Data

Culture, bacterial

Facility: Ohiohealth Morrow County Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $84
  • Cash Discount Price: $146
  • vs. Medicare Baseline: 9.74x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Ohiohealth Morrow County Hospital is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 9.74x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.
Cash / Self-Pay
$146

Average discount available for prompt cash payment at this facility.

Insurance Median
$84

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: $146 (1694%)
Insurance Median: $84 (974%)
Cash: $146 (1694% of Medicare)
Ins. Median: $84 (974% 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 974% of the Medicare baseline (a markup of 874%). 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
Blue Cross Blue Shield $4 - $83 46%
Medicaid / KanCare $20 - $21 232%
UnitedHealthcare $20 - $184 232%
Amerihealth Caritas - All Plans $21 244%
Humana $21 - $209 244%
Molina Exchange - All Other Plans $34 394%
Medicare (plans) $83 - $85 963%
Aetna $85 - $193 986%
Caresource Marketplace - All Other Plans $104 1206%
Medical Mutual Of Ohio Marketplace $168 1949%
Ohiohealthy Network - All Other Plans $168 1949%
Ohiohealthy Preferred $168 1949%
Medical Mutual Of Ohio Comm - All Other Plans $182 2111%
Medical Mutual Of Ohio - Admin Serv $191 2216%
Phcs - All Plans $206 2390%
Cigna $211 2448%
Multiplan - All Plans $213 2471%
Healthstar Comm - All Plans $215 2494%
Beech Street - All Plans $217 2517%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 West Marion Road, Mount Gilead, OH 43338
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals