CMS Price Transparency Data

Culture, bacterial

Facility: Sonoma Valley Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $60
  • Cash Discount Price: $192
  • vs. Medicare Baseline: 6.96x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Sonoma Valley Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 6.96x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$192

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $192 (2227%)
Insurance Median: $60 (696%)
Cash: $192 (2227% of Medicare)
Ins. Median: $60 (696% 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 696% of the Medicare baseline (a markup of 596%). 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
Tricare $8 93%
Blue Cross Blue Shield $9 - $274 104%
Bright Hlth/Brand New Day Mcr Adv $9 104%
Hospice Of Marin-All Plans $9 104%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $9 104%
St Joseph Heritage Hltcare Comm-All Other Plans $9 104%
Veterans Admin-All Plans $9 104%
Cdcr Prison-All Plans $10 116%
Medi-Cal $10 116%
Partnership Healthplan-All Plans $10 116%
Three Rivers (Trpn)-All Plans $10 116%
Chp - Correctional Health Partners - All Plans $11 128%
Bright Hlth/Brand New Day - All Other Plands $12 139%
Wellpath - All Plans $12 139%
Aetna $14 162%
First Health(Coventry)-All Plans $14 162%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $16 186%
Canopy Health Solutions-All Other Plans $16 186%
Mcal Mgd Care (Php)-All Plans $16 186%
UnitedHealthcare $17 197%
Meritage Medical Network Op Only Mcare $24 278%
Meritage Medical Network Op Only-All Other Plans $24 278%
Healthnet Hmo/Ppo-All Other Plans $96 1114%
Blue Shield Ppo-All Plans $156 1810%
Kaiser-All Plans $178 2065%
Integrated Health Plan-All Plans $203 2355%
Champus-All Plans $219 2541%
Cigna $219 2541%
Networks By Design - All Plans $219 2541%
Comm Care Network(Ccn)-All Plans $233 2703%
Great West-One Health Plan Ppo/Pos-All Plans $233 2703%
Phcs/Multiplan/Beech St-All Plans $233 2703%
Interplan-All Plans $241 2796%
Bps-All Plans $247 2865%
Ppo Alliance-All Plans $247 2865%
Pref Health Networl(Phn)-All Plans $247 2865%
Scan Mcare-All Plans $274 3179%
St Joseph Heritage Hltcare Mcr Adv $274 3179%
Correct Care Integ Health-All Plans $329 3817%
Employer Direct Healthcare-All Plans $329 3817%
Creative Legal Services-All Plans $356 4130%
Canopy Op Only $493 5719%
Vnpn - All Plans $493 5719%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals