CMS Price Transparency Data

Culture, bacterial

Facility: Galion Community Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $111
Cash Discount Price: $123
vs. Medicare Baseline: 12.88x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Galion Community Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 12.88x the Medicare baseline. Located in 269 Portland Way South, Galion, OH.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $123 (1427%)

Insurance Median: $111 (1288%)

Cash: $123 (1427% of Medicare)

Ins. Median: $111 (1288% 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 1288% of the Medicare baseline (a markup of 1188%). 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
Caresource	$28	325%
Medicaid / KanCare	$28	325%
Ohiorise	$28	325%
Amerihealth	$29	336%
Blue Cross Blue Shield	$29 - $4,142	336%
Molina	$29 - $5,629	336%
United_Healthcare	$29 - $4,142	336%
Buckeye	$30 - $4,142	348%
Humana	$30 - $4,142	348%
Medicare (plans)	$49 - $4,142	568%
Mount_Carmel	$49 - $4,142	568%
Aetna	$50 - $4,224	580%
Medical_Mutual	$116 - $4,224	1346%
Cigna	$128	1485%

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 $123.
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 Galion Community 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.