Culture, bacterial
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $228
- Cash Discount Price: $304
- vs. Medicare Baseline: 26.45x 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 2645% of the Medicare baseline (a markup of 2545%). 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 | $182 | 2111% |
| Americas Choice Provider Network | $213 | 2471% |
| Usa Managed Care Organization | $228 | 2645% |
| Provider Network Of America | $228 | 2645% |
| Quiktrip Corporation | $228 | 2645% |
| Velocity | $228 | 2645% |
| Multiplan-Phcs | $243 | 2819% |
| Prime Health Services | $258 | 2993% |
| Medincrease | $273 | 3167% |
Consumer Guidance & Cost Commentary
For the bacterial culture service (CPT 87070) at the Rehabilitation Hospital Of Overland Park, the cash price is $304.00, which matches the facility's median cash rate. This cash price is significantly higher than the Medicare benchmark of $8.62, reflecting the standard markup found in commercial healthcare pricing. While the facility's negotiated rates with insurance payers range from $182 to $273, these amounts are still notably above the Medicare baseline. Patients with high-deductible plans may find the cash price of $304.00 more affordable than the negotiated rates if their insurance allows for balance billing or if the deductible has not yet been met, as the administrative overhead often inflates the insurance rate by 20% to 40% above the true cost of care.
To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is important to verify the specific allowed amount for your insurance plan before the visit, as in-network rates vary significantly across different carriers and do not guarantee the lowest possible price. Additionally, since over 80% of hospital bills contain errors, consumers should request a detailed, itemized statement rather than accepting a summary bill, which can help identify unbundled codes or services not rendered. Always compare the facility's pricing against the Medicare benchmark to understand the true cost structure, rather than relying on the hospital's gross chargemaster list which is inflated to make discounts appear larger.