CMS Price Transparency Data

Culture, bacterial

Facility: Banner Payson Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $31
  • Cash Discount Price: $24
  • vs. Medicare Baseline: 3.60x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Banner Payson Medical Center is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 3.60x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$24

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $24 (278%)
Insurance Median: $31 (360%)
Cash: $24 (278% of Medicare)
Ins. Median: $31 (360% 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 360% of the Medicare baseline (a markup of 260%). 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
Arizona Physicians Ipa $9 - $31 104%
Banner University Health Plan $9 - $31 104%
Health Choice Arizona, Inc. $9 - $44 104%
Health Net $9 - $46 104%
Mercy Care $9 - $31 104%
Aetna $11 - $50 128%
Banner Health $11 - $31 128%
Blue Cross Blue Shield $11 - $41 128%
Care 1St $11 - $31 128%
Carelon $11 - $32 128%
Cigna $11 - $60 128%
Gila River Health Care Corporation $11 - $31 128%
Humana $11 - $33 128%
Kaiser Foundation Health Plan $11 - $31 128%
Triwest Healthcare Alliance Corp - Va Ccn $11 - $31 128%
UnitedHealthcare $11 - $50 128%
Upmc Health Plan $11 - $31 128%
Wellpoint $11 - $31 128%
Arizona Priority Care $12 - $34 139%
Devoted Health Services $12 - $34 139%
Gold Kidney Health Plan $12 - $34 139%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $12 - $34 139%
Plotkin Health $12 - $34 139%
Oscar Health Plan $18 - $51 209%
Quiktrip Corporation $18 - $52 209%
Arizona Medical Network $23 - $68 267%
Provider Network Of America $23 - $68 267%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 807 South Ponderosa Drive, Payson, AZ 85541
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals