CMS Price Transparency Data

Culture, bacterial

Facility: Adventist Health Sonora

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $85
  • Cash Discount Price: $28
  • vs. Medicare Baseline: 9.86x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Adventist Health Sonora is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 9.86x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.
Cash / Self-Pay
$28

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

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: $28 (325%)
Insurance Median: $85 (986%)
Cash: $28 (325% of Medicare)
Ins. Median: $85 (986% 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 986% of the Medicare baseline (a markup of 886%). 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
Kaiser - All Plans $4 - $402 46%
UnitedHealthcare $4 - $692 46%
Western Growers/Pinnacle - All Plans $4 - $427 46%
Beech Street- All Plans $6 - $684 70%
Blue Shield - All Other Plans $6 - $612 70%
Blue Shield Epn $6 - $610 70%
Greatwest Oa/Pos/Hmo $6 - $684 70%
Trpn - Three Rivers Ppo - All Plans $6 - $644 70%
Affordable Health - All Plans $7 - $724 81%
Cigna $7 - $765 81%
Greatwest Ppo - All Other Plans $7 - $724 81%
Healthnet - All Other Plans $7 - $705 81%
Interplan - All Plans $7 - $724 81%
Multiplan - All Plans $7 - $724 81%
Phcs Ppo - All Plans $7 - $724 81%
Stanilaus Foundation - All Plans $7 - $765 81%
Celtic Ca Hlth Well Mcal - All Plans $8 - $14 93%
Central Ca Alliance Ccs Mcal $8 - $11 93%
Central Ca Alliance Chdp Mcal $8 - $11 93%
Central Ca Alliance Mcal $8 - $11 93%
Healthnet Mcal $8 - $15 93%
Medi-Cal $8 - $10 93%
Aetna $9 - $87 104%
Blue Shield Mcare $9 104%
Healthnet Mcr Adv $9 104%
Phs Prime Health Srvcs-All Plans $9 104%
Tricare $9 104%
Ah Employee Health Plan - All Plans $16 186%
Bc Exchange $78 905%
Bc Non-Mcs - All Other Plans $87 1009%
Bc Mcs $104 1206%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Greenley Road, Sonora, CA 95370
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals