CMS Price Transparency Data

Culture, bacterial

Facility: San Gabriel Valley Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $221
  • Cash Discount Price: $168
  • vs. Medicare Baseline: 25.64x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at San Gabriel Valley Medical Center is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 25.64x the Medicare baseline. Located in 438 W Las Tunas Drive, San Gabriel, CA.
Cash / Self-Pay
$168

Average discount available for prompt cash payment at this facility.

Insurance Median
$221

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: $168 (1949%)
Insurance Median: $221 (2564%)
Cash: $168 (1949% of Medicare)
Ins. Median: $221 (2564% 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 2564% of the Medicare baseline (a markup of 2464%). 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
Veterans Administration $6 70%
Aetna $8 - $15 93%
Ahmc Medi-Cal Reciprocity $8 93%
Alignment Health Plan $8 93%
Allied Physicians $8 - $13 93%
Altamed Health Network $8 93%
Apa/Aco Inc $8 93%
Avanti $8 - $10 93%
Beverly Hospital $8 - $9 93%
Blue Cross Blue Shield $8 - $42 93%
Blue Shield Of California $8 - $121 93%
Brand New Day $8 - $204 93%
Central Health Plan $8 - $350 93%
Emanate Health $8 - $11 93%
Health Net $8 - $339 93%
Health Net Inc $8 - $20 93%
Healthnet Medi-Cal Non-Contract $8 93%
Healthy Way La $8 93%
Humana $8 93%
La Care Health Plan $8 - $9 93%
Medicare (plans) $8 93%
Molina Healthcare Of California $8 - $227 93%
Non Contracting Medi Cal $8 93%
Pacific Alliance Medical Center $8 93%
Pacificare Of California $8 - $191 93%
Providence Health Network $8 93%
Tricare $8 93%
Wellcare $8 93%
Aids Healthcare Foundation $9 - $233 104%
Cv-19 Hrsa Uninsured Testing And Tx $9 104%
Hollywood Presbyterian Adv Med Mcal $9 104%
Hollywood Presbyterian Medpoint Mcal $9 104%
Inter Valley Health Plan $9 104%
Medicaid / KanCare $9 104%
Physicians Healthways $9 104%
Self-Pay $9 104%
St Vincent Medical Center/Psych $9 104%
Athens Administrators $10 116%
Beech Street $10 - $466 116%
Chinatown Service Center Pace $10 116%
Cigna $10 116%
Other Non Contracting Workers Comp $10 116%
Ahmc Health Self-Insurance Epo $11 128%
Care 1St Health Plan $11 - $379 128%
Knox-Keene Act $11 128%
UnitedHealthcare $17 - $34 197%
Private Pay $25 290%
Ahmc Reciprocity $119 - $175 1381%
Alignment Healthplan $139 - $204 1613%
Clever Care $139 - $204 1613%
Pacific Independent Physician Associates $159 - $233 1845%
Facey Medical $199 - $292 2309%
Community Care Network $259 - $379 3005%
Choicecare Network $279 - $408 3237%
Private Healthcare Systems (Phcs) $279 - $408 3237%
Affiliated Health Fund $298 - $437 3457%
Multiplan $358 - $525 4153%
Ppo Next $358 - $525 4153%
Managed Health Network $398 - $583 4617%
Medi-Cal Sub Acute $398 - $583 4617%
One Legacy $398 - $583 4617%
Other Non Contracted Commercial $398 - $583 4617%
Us Behavioral Health Plan $398 - $583 4617%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 438 W Las Tunas Drive, San Gabriel, CA 91776
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals