Culture, bacterial
Facility: Salina Regional Health Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $47
- Cash Discount Price: $44
- vs. Medicare Baseline: 5.45x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 545% of the Medicare baseline (a markup of 445%). 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.
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 | $20 - $21 | 232% |
| Preferred Phsic | $32 - $44 | 371% |
| Preferred Healthcare - All Other Plans | $43 - $60 | 499% |
| Aetna | $47 - $66 | 545% |
| Providers Care (Wppa)-All Plans | $47 - $66 | 545% |
| Multiplan (Mpi)-All Plans | $47 - $66 | 545% |
| Cigna | $47 - $66 | 545% |
Consumer Guidance & Cost Commentary
For this bacterial culture service at Salina Regional Health Center in Salina, KS, the facility's cash median price of $44.00 is lower than the state average of $47.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and Preferred Phsic range from $20 to $66, these amounts often exceed the cash price, meaning patients with high-deductible plans or those without insurance may save money by paying the cash rate directly. To secure this lower rate, patients should explicitly request a "self-pay" classification and ask about prompt-pay discounts before scheduling, as waiting until after receiving an insurance bill can result in the facility submitting a claim that voids the cash agreement.
The facility's billing practices align with federal protections under the No Surprises Act, which prevents balance billing for out-of-network services at in-network facilities like this acute care hospital. However, patients should always request a full itemized bill before paying, as summary invoices can obscure unbundled charges or services not rendered. For context, the facility's Medicare benchmark amount of $8.62 serves as the objective baseline for pricing; while commercial negotiated rates are typically higher due to administrative costs, the cash price here remains competitive compared to the state average. If you receive a bill that seems inconsistent with these rates, you have the right to dispute it in writing to the billing supervisor rather than accepting a verbal settlement.