CMS Price Transparency Data

Culture, bacterial

Facility: Oakleaf Surgical Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $9
  • Cash Discount Price: $162
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Oakleaf Surgical Hospital is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $162. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.04x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$162

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $162 (1879%)
Insurance Median: $9 (104%)
Cash: $162 (1879% of Medicare)
Ins. Median: $9 (104% 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.

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%
Dean Health Plan $9 104%
Group Health Cooperative Of Eau Claire $9 104%
Healthpartners $9 104%
Humana $9 104%
Medica $9 104%
Quartz Health Solutions $9 104%
Security Health Plan Of Wi $9 104%
Ucare Wi $9 104%
UnitedHealthcare $9 104%

Consumer Guidance & Cost Commentary

Oakleaf Surgical Hospital in Altoona, Wisconsin, reported a cash median rate of $162 for CPT code 87070 (Culture, bacterial) based on the 2026-06 vintage data. This facility operates under physician ownership and has a gross charge of $180, with a median negotiated rate of $9 across ten payers, including Blue Cross Blue Shield, Humana, and UnitedHealthcare. The Medicare amount for this service is listed at $8.62. While the data provided does not include specific comparative averages for the county or state, the stark difference between the cash price and the negotiated rates highlights how insurance contracts can significantly alter the final cost for patients.

For patients with high-deductible plans, paying the cash price of $162 upfront may be more cost-effective than relying on insurance, as the commercial negotiated rate of $9 is lower, yet many plans require the patient to meet a deductible before this reduced amount applies. It is important to verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can further reduce the bill for those paying in full. Additionally, while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should request an itemized billing audit to ensure no unbundled codes or services not rendered are included in the final statement.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals