CMS Price Transparency Data

Culture, bacterial

Facility: Adventist Health and Rideout

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $146
Cash Discount Price: $57
vs. Medicare Baseline: 16.94x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Adventist Health and Rideout is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 16.94x the Medicare baseline. Located in 726 4Th St, Marysville, CA.

Cash / Self-Pay

$57

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $57 (661%)

Insurance Median: $146 (1694%)

Cash: $57 (661% of Medicare)

Ins. Median: $146 (1694% 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 1694% of the Medicare baseline (a markup of 1594%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Bc Mcal	$2	23%
Healthnet Mcal	$3 - $92	35%
Healthnet Comm-All Other Plans	$8 - $276	93%
Aetna	$9 - $326	104%
Blue Cross Blue Shield	$9 - $355	104%
Kaiser Mcr Adv	$9	104%
Tricare	$9	104%
UnitedHealthcare	$9 - $400	104%
Blue Shield Uc Care Members	$10 - $369	116%
Kaiser Mcal	$10	116%
Kaiser-All Other Plans	$10 - $350	116%
Medi-Cal	$10	116%
Partnership Hp Mcal -All Plans	$10	116%
Cigna	$11 - $393	128%
First Health-All Plans	$11 - $403	128%
Phcs-All Plans	$11 - $406	128%
Blue Shield-All Other Plans	$12 - $438	139%
Ca Health And Wellness- All Plans	$12	139%
Celtic Mcaid-All Plans	$12	139%
Interplan-All Plans	$12 - $415	139%
Multiplan-All Plans	$12 - $438	139%
Ah Employee Health Plan - All Plans	$16	186%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $57.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87070.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health and Rideout is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 87070.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.