CMS Price Transparency Data
Culture, bacterial
Facility: Mercy St Francis Hospital
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $147
- Cash Discount Price: $112
- vs. Medicare Baseline: 17.05x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercy St Francis Hospital is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 17.05x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.
Cash / Self-Pay
$112
Average discount available for prompt cash payment at this facility.
Insurance Median
$147
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: $112 (1299%)
Insurance Median: $147 (1705%)
Cash: $112 (1299% of Medicare)
Ins. Median: $147 (1705% 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 1705% of the Medicare baseline (a markup of 1605%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $7 - $99 | 81% |
| Halo Hcr Inc Hospice Contracted [320432] | $8 - $66 | 93% |
| Kindful Hospice [20434] | $8 - $66 | 93% |
| Qual Choice Contracted [320325] | $8 - $66 | 93% |
| Cherokee Nation Health Serv Contracted [320066] | $8 - $66 | 93% |
| Halo Hcr Inc Hospice [20432] | $8 - $66 | 93% |
| Indian Health Service Contracted [320198] | $8 - $66 | 93% |
| Acentra Health Contracted [320527] | $8 | 93% |
| Mercy Hospice Okc [20252] | $8 - $66 | 93% |
| Cross Timbers Hospice [20098] | $8 - $66 | 93% |
| Dept of Veteran Affairs Contracted [320106] | $8 - $66 | 93% |
| Medicare (plans) | $8 - $68 | 93% |
| Kindful Hospice Contracted [320434] | $8 - $66 | 93% |
| Pace of the Ozarks Contracted [320518] | $8 - $66 | 93% |
| Mercy Mgd Behavioral Health Contracted [320259] | $8 - $66 | 93% |
| Blue Cross Blue Shield | $8 - $185 | 93% |
| Elara Caring Aspire Hospice [20433] | $8 - $66 | 93% |
| Medical Associates Health Contracted [320444] | $8 - $66 | 93% |
| UnitedHealthcare | $12 - $181 | 139% |
| Centivo Contracted [320505] | $14 - $111 | 162% |
| Globalhealth Contracted [320145] | $43 - $66 | 499% |
| Cigna | $43 - $181 | 499% |
| Aetna | $43 - $170 | 499% |
| Humana | $43 - $172 | 499% |
| Provider Partners Health Plans Contracted [320450] | $43 - $66 | 499% |
| Tricare | $53 - $65 | 615% |
| Healthscope Contracted [320182] | $53 - $87 | 615% |
| Administrative Payor Contracted [320005] | $70 - $86 | 812% |
| Ambetter / Centene | $80 - $99 | 928% |
| Home State Health Plan Contracted [320187] | $80 - $99 | 928% |
| Novasys Contracted [320285] | $80 - $99 | 928% |
| Preferred Health Plan Contracted [320522] | $101 - $124 | 1172% |
| Healthlink Contracted [320179] | $101 - $181 | 1172% |
| Workers Comp [20426] | $124 - $162 | 1439% |
| Point C Contracted [320238] | $140 - $181 | 1624% |
| Mercy Benefit Admin Contracted [320251] | $140 - $181 | 1624% |
| Auxiant Contracted [320462] | $140 - $181 | 1624% |
| United Medical Resources Contracted [320454] | $140 - $178 | 1624% |
| Medica Contracted [320239] | $146 - $180 | 1694% |
| Reflect Health Contracted [320492] | $147 - $181 | 1705% |
| Insurance System Inc Contracted [320465] | $147 - $181 | 1705% |
| Point C [20238] | $147 - $181 | 1705% |
| USA Managed Care Org Contracted [320429] | $147 - $181 | 1705% |
| First Health Contracted [320128] | $147 - $181 | 1705% |
| Private Health Care Systems Contracted [320320] | $147 - $181 | 1705% |
| Yuzu Health Contracted [320521] | $147 - $181 | 1705% |
| Ebms Contracted [320493] | $147 - $181 | 1705% |
| 90 Degree Benefits Contracted [320436] | $147 - $181 | 1705% |
| Health Systems Inc Contracted [320174] | $147 - $181 | 1705% |
| Edison Health Solutions Contracted [320502] | $147 - $181 | 1705% |
| Imagine 360 Contracted [320494] | $147 - $181 | 1705% |
| Aither Health Contracted [320449] | $147 - $181 | 1705% |
| Benefit Management Contracted [320052] | $147 - $181 | 1705% |
| Evolutions Health Care Contracted [320124] | $147 - $181 | 1705% |
| Multiplan Contracted [320270] | $147 - $181 | 1705% |
| Show-Me Health Administrators Contracted [320483] | $147 - $181 | 1705% |