CMS Price Transparency Data

Culture, bacterial

Facility: Saint Agnes Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $49
  • Cash Discount Price: $495
  • vs. Medicare Baseline: 5.68x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Saint Agnes Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $495. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 5.68x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$495

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $495 (5742%)
Insurance Median: $49 (568%)
Cash: $495 (5742% of Medicare)
Ins. Median: $49 (568% 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 568% of the Medicare baseline (a markup of 468%). 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
Aetna $8 - $208 93%
Blue Cross Blue Shield $8 - $322 93%
Humana $8 - $34 93%
Medicare (plans) $8 - $36 93%
UnitedHealthcare $9 - $70 104%
Welbe Health $9 - $35 104%
Align Senior Care $10 - $40 116%
Correctcare Integrated Health $11 - $43 128%
Medi-Cal Healthnet $12 - $53 139%
Geha $15 - $58 174%
Kaiser Permanente $15 - $60 174%
Advantek Central Usd $21 - $85 244%
Blue Shield - Ca $25 - $322 290%
Meritain $49 - $197 568%
Trustmark Small Business Benefits $49 - $197 568%
Allied Benefit Systems $52 - $208 603%
Boon Chapman $52 - $208 603%
Hap $52 - $208 603%
Webtpa $52 - $208 603%
St Agnes Nicu Valley Childrens Hospital $77 893%
Healthnet $80 - $96 928%
Blue Benefit Administrators Of Massachusetts $81 - $322 940%
Blue Care Network $81 - $322 940%
Blue Distinction Transplant $81 - $322 940%
Blue Shield - Id (Regence) $81 - $322 940%
Blue Shield - Ny Highmark Northeastern $81 - $322 940%
Blue Shield - Ny Highmark Western $81 - $322 940%
Blue Shield - Pa (Highmark) $81 - $322 940%
Blue Shield - Wa (Regence) $81 - $322 940%
Coventry $81 940%
Cba Network By Design $88 1021%
Network Health $88 1021%
Allegiance $91 1056%
American Postal Workers Secondary $91 1056%
Cigna $91 1056%
Multiplan $99 1148%
Phcs $99 1148%
Interplan $106 1230%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals