CMS Price Transparency Data
Culture, bacterial
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $69
- Cash Discount Price: $148
- vs. Medicare Baseline: 8.00x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at AHMC Anaheim Regional Medical Center is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 8.00x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$148
Average discount available for prompt cash payment at this facility.
Insurance Median
$69
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: $148 (1717%)
Insurance Median: $69 (800%)
Cash: $148 (1717% of Medicare)
Ins. Median: $69 (800% 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 800% of the Medicare baseline (a markup of 700%). 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 |
|---|---|---|
| Veterans Administration | $6 | 70% |
| Affiliated Doctors Of Orange County | $7 | 81% |
| Aetna | $8 - $47 | 93% |
| Ahmc Reciprocity Agreement | $8 - $126 | 93% |
| Aids Health Foundation | $8 - $9 | 93% |
| Alignment Health Plan | $8 | 93% |
| Allied Physicians | $8 - $13 | 93% |
| Alta Los Angeles Hospital | $8 | 93% |
| Altamed Health Network | $8 | 93% |
| Apa Aco Inc | $8 | 93% |
| Applecare Medical Group | $8 | 93% |
| Avanti | $8 - $10 | 93% |
| Beverly Hospital | $8 - $9 | 93% |
| Blue Cross Blue Shield | $8 - $32 | 93% |
| Blue Shield Of California | $8 - $116 | 93% |
| Brand New Day | $8 - $11 | 93% |
| California Health Plan | $8 | 93% |
| Caloptima | $8 - $11 | 93% |
| Central Health Of California | $8 | 93% |
| Davita Heatlhcare Partners Plan Inc | $8 - $227 | 93% |
| Health Net | $8 | 93% |
| Healthcare Partners | $8 | 93% |
| Healthnet | $8 | 93% |
| Healthy Way La | $8 | 93% |
| Heritage Provider Network | $8 - $12 | 93% |
| Humana | $8 | 93% |
| Kaiser Foundation Hospitals | $8 | 93% |
| Medical Safety Net Program | $8 | 93% |
| Medicare (plans) | $8 - $210 | 93% |
| Monarch Health Plan | $8 - $285 | 93% |
| Non Contracted Medi-Cal | $8 | 93% |
| Pacificare | $8 | 93% |
| Prospect Health Plan | $8 - $12 | 93% |
| Prospect Medical Group | $8 | 93% |
| Scan Health Plan | $8 | 93% |
| Seoul Medical Group | $8 - $9 | 93% |
| Talbert Medical Group | $8 - $9 | 93% |
| Wellcare | $8 | 93% |
| Align Senior Care | $9 | 104% |
| Angels Baseball Workers Comp | $9 | 104% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $9 | 104% |
| Emanate Health | $9 - $11 | 104% |
| Health Net Inc | $9 - $323 | 104% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $9 | 104% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $9 | 104% |
| Hollywood Presbyterian Medpoint Mcal | $9 | 104% |
| Innovative Integrated Health (Iih)/Orange County Pace | $9 | 104% |
| Interplan | $9 - $294 | 104% |
| Medi-Cal | $9 | 104% |
| Memorial Healthcare Ipa/Cap/Valuation Rates | $9 | 104% |
| Nchp | $9 | 104% |
| Private Pay Flat Rate | $9 | 104% |
| Self-Pay | $9 | 104% |
| Tricare | $9 | 104% |
| Athens Administrators | $10 | 116% |
| Capp Care | $10 - $315 | 116% |
| Cigna | $10 | 116% |
| Corvel | $10 - $315 | 116% |
| First Health | $10 - $357 | 116% |
| Marriot Intl | $10 | 116% |
| Non Contracted Workers Comp | $10 | 116% |
| Orange County Preferred Provider Organization | $10 - $315 | 116% |
| Ahmc Health Self-Insurance Epo | $11 | 128% |
| Knox-Keene Act | $11 | 128% |
| Netcare Life And Health Insurance | $12 - $105 | 139% |
| Advance Clinical Research Institute | $14 - $126 | 162% |
| Memorial Healthcare Ipa | $14 - $126 | 162% |
| UnitedHealthcare | $17 - $34 | 197% |
| Medical Acquisition Company | $19 - $168 | 220% |
| Monarch Healthcare Medical Group | $22 | 255% |
| Healthcare Partners Commercial | $25 - $227 | 290% |
| Huntington Memorial Hospital | $25 - $227 | 290% |
| Genesis Healthcare Ipa Ancillary | $28 - $252 | 325% |
| Affiliated Health Fund | $33 - $294 | 383% |
| Allnet Preferred Provider | $33 - $294 | 383% |
| Care First | $33 - $294 | 383% |
| Private Healthcare Systems | $33 - $294 | 383% |
| Choicecare | $35 - $315 | 406% |
| Multiplan Inc | $35 - $315 | 406% |
| National Provider Network | $38 - $336 | 441% |
| Three Rivers Providers Network | $38 - $336 | 441% |
| Health Payors Organization | $42 - $378 | 487% |
| Non Contracted Commercial | $47 - $420 | 545% |
| Msi/Medical Services For Indigents | $52 | 603% |