CMS Price Transparency Data

Culture, bacterial

Facility: Ascension Ne Wisconsin - St Elizabeth Campus

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $12
Cash Discount Price: $44
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Ascension Ne Wisconsin - St Elizabeth Campus is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.39x the Medicare baseline. Located in 1506 S Oneida St, Appleton, WI.

Cash / Self-Pay

$44

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $44 (510%)

Insurance Median: $12 (139%)

Cash: $44 (510% of Medicare)

Ins. Median: $12 (139% 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.

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
Blue Cross Blue Shield	$9	104%
Medicare (plans)	$9	104%
Veterans Administration	$9	104%
Wellcare	$9	104%
Alliance	$12	139%
Centivo Nw1	$12	139%
Centivo Nw3	$12	139%
Smarthealth	$12	139%
Sehn	$17	197%
Molina Marketplace	$18	209%
Network Health Plan	$19	220%
Cchp	$29	336%
Cigna	$33	383%

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 $44.
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 Ascension Ne Wisconsin - St Elizabeth Campus 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.