CMS Price Transparency Data

Culture, bacterial

Facility: Adventist Health Sierra Vista

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $197
Cash Discount Price: $28
vs. Medicare Baseline: 22.85x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Adventist Health Sierra Vista is $197. 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 22.85x the Medicare baseline. Located in 1010 Murray St, San Luis Obispo, CA.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$197

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: $197 (2285%)

Cash: $28 (325% of Medicare)

Ins. Median: $197 (2285% 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 2285% of the Medicare baseline (a markup of 2185%). 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
Hpn-Heritage Prov Ntwrk-All Plans	$4 - $448	46%
UnitedHealthcare	$4 - $531	46%
Blue Shield Epn	$5 - $605	58%
Blue Shield Hmo/Pos	$6 - $833	70%
Blue Shield Epo/Ppo-All Other Plans	$7 - $918	81%
Nbd-Ntwrks By Design Exclus-All Other Plans	$7 - $811	81%
Nbd-Ntwrks By Design Non-Exclus	$7 - $986	81%
Aetna	$9	104%
Cencal Mcr Adv - All Other Plans	$9	104%
Tricare	$9	104%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$11	128%
Medi-Cal	$13 - $1,707	151%
Blue Shield Promise Mcal	$15 - $2,052	174%
Cencal Mcal	$15 - $1,601	174%
Ah Employee Health Plan - All Plans	$16	186%
Ccah-Centrl Ca Allince Mcal-All Plans	$17 - $1,825	197%
Coalinga-All Plans	$17 - $1,825	197%

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 $28.
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 Sierra Vista 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.