CMS Price Transparency Data

Culture, bacterial

Facility: Mercy Hospital Ada

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $105
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 12.18x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercy Hospital Ada is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 12.18x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $114 (1323%)
Insurance Median: $105 (1218%)
Cash: $114 (1323% of Medicare)
Ins. Median: $105 (1218% 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 1218% of the Medicare baseline (a markup of 1118%). 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 $8 - $159 93%
Blue Cross Blue Shield $8 93%
Cherokee Nation Health Serv Contracted [320066] $8 93%
Cross Timbers Hospice [20098] $8 93%
Dept Of Veteran Affairs Contracted [320106] $8 93%
Elara Caring Aspire Hospice Contracted [320433] $8 93%
Elara Caring Aspire Hospice [20433] $8 93%
Halo Hcr Inc Hospice Contracted [320432] $8 93%
Halo Hcr Inc Hospice [20432] $8 93%
Humana $8 93%
Independent Health [20197] $8 93%
Indian Health Service Contracted [320198] $8 93%
Kindful Hospice Contracted [320434] $8 93%
Kindful Hospice [20434] $8 93%
Medicaid / KanCare $8 - $12 93%
Medical Associates Health [20444] $8 93%
Medicare (plans) $8 - $211 93%
Mercy Hospice Okc [20252] $8 93%
Provider Partners Health Plans Contracted [320450] $8 93%
Qual Choice Contracted [320325] $8 93%
Tricare $8 93%
UnitedHealthcare $8 - $11 93%
Cigna $9 104%
Globalhealth Contracted [320145] $9 104%
Medica Contracted [320239] $11 - $211 128%
United Medical Resources Contracted [320454] $11 - $127 128%
Ambetter / Centene $12 139%
Health Choice Contracted [320166] $12 139%
Home State Health Plan Contracted [320187] $12 139%
Novasys Contracted [320285] $12 139%
Workers Comp [20426] $15 174%
Healthsmart Preferred Care Contracted [320184] $19 220%
Kempton Contracted [320214] $19 220%
Healthcare Highways Plus Contracted [320175] $23 - $158 267%
Webtpa Contracted [320417] $25 - $89 290%
Osma Health Contracted [320292] $27 - $95 313%
Benefit Management Contracted [320052] $30 - $137 348%
Aither Health Contracted [320449] $35 - $127 406%
Auxiant Contracted [320462] $35 - $127 406%
Ebms Contracted [320493] $35 - $127 406%
Federal Medical Center Contracted [320127] $35 - $127 406%
Healthlink Contracted [320179] $35 - $127 406%
Healthscope Contracted [320182] $35 - $127 406%
Imagine 360 Contracted [320494] $35 - $127 406%
Mercy Benefit Admin Contracted [320251] $35 - $137 406%
Point C Contracted [320238] $35 - $127 406%
Preferred Health Plan Contracted [320522] $35 - $127 406%
Quik Trip Contracted [320447] $35 - $127 406%
Reflect Health Contracted [320492] $35 - $127 406%
Show-Me Health Administrators Contracted [320483] $35 - $127 406%
Yuzu Health Contracted [320521] $35 - $127 406%
Globalhealth Contracted [320144] $37 - $133 429%
First Health Contracted [320128] $49 - $175 568%
Multiplan Contracted [320270] $50 - $179 580%
Private Health Care Systems Contracted [320320] $50 - $179 580%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 North Monte Vista, Ada, OK 74820
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals