CMS Price Transparency Data

Culture, bacterial

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $142
Cash Discount Price: $275
vs. Medicare Baseline: 16.47x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $275. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 16.47x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$275

Average discount available for prompt cash payment at this facility.

Insurance Median

$142

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: $275 (3190%)

Insurance Median: $142 (1647%)

Cash: $275 (3190% of Medicare)

Ins. Median: $142 (1647% 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 1647% of the Medicare baseline (a markup of 1547%). 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
Blue Cross Blue Shield	$9 - $45	104%
Group Health Cooperative Of Eau Claire	$9 - $399	104%
Humana	$9 - $374	104%
Icare	$9 - $10	104%
Managed Health Services	$9	104%
Molina Healthcare Of Wi	$9 - $357	104%
My Choice	$9	104%
Network Health Plan	$9 - $351	104%
Quartz	$9 - $240	104%
Security Health Plan (Shp)	$9 - $243	104%
Trilogy	$9 - $378	104%
UnitedHealthcare	$9 - $30	104%
Veteran'S Administration (Va Ccn)	$9	104%
The Alliance	$80 - $213	928%
Amish/Mennonite	$87 - $231	1009%
Wps Health Insurance	$106 - $283	1230%
Cigna	$107 - $311	1241%
Health Payment Systems	$110 - $292	1276%
First Health	$134 - $357	1555%
Healtheos By Multiplan Inc.	$147 - $399	1705%
Health Partners	$150 - $399	1740%
Coventry	$152 - $403	1763%

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 $275.
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 Marshfield Medical Center - Beaver Dam (Mmc-Bd) 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.