CMS Price Transparency Data

Culture, bacterial

Facility: St Joseph's Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $134
  • Cash Discount Price: $150
  • vs. Medicare Baseline: 15.55x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at St Joseph's Hospital is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 15.55x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$150

Average discount available for prompt cash payment at this facility.

Insurance Median
$134

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: $150 (1740%)
Insurance Median: $134 (1555%)
Cash: $150 (1740% of Medicare)
Ins. Median: $134 (1555% 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 1555% of the Medicare baseline (a markup of 1455%). 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.

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
Caterpillar, Inc. $17 197%
Molina Healthcare $17 - $42 197%
UnitedHealthcare $17 - $209 197%
Meridian Health Plan $18 209%
Cigna $21 244%
Sae Hospice $42 487%
Humana $42 487%
Blue Cross Blue Shield $42 487%
Aetna $42 - $146 487%
Clear Spring Health of Illinois $42 487%
Amish Community $59 684%
Naphcare $88 1021%
Celtic Insurance Company $92 1067%
Hopetrust $104 1206%
Claim Doc $104 1206%
Wellfirst $134 1555%
First Health $154 1787%
Multiplan/Phcs $178 2065%
Healthlink $178 2065%
Healthcare Finest Network (Hfn) $188 2181%
Provider Network of America $188 2181%
Healthscope $209 2425%
Health Alliance Medical Plans $209 2425%
Mental Health Network $209 2425%
Consociate Group $209 2425%
Illinois Breast and Cervical Cancer Program $209 2425%
Interplan $209 2425%
Current Health Solutions $209 2425%
Qtc Medical Group of Illinois $209 2425%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals