CMS Price Transparency Data

Culture, bacterial

Facility: Adventist Health Twin Cities

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $177
Cash Discount Price: $15
vs. Medicare Baseline: 20.53x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Adventist Health Twin Cities is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 20.53x the Medicare baseline. Located in 1100 Las Tablas Rd, Templeton, CA.

Cash / Self-Pay

$15

Average discount available for prompt cash payment at this facility.

Insurance Median

$177

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: $15 (174%)

Insurance Median: $177 (2053%)

Cash: $15 (174% of Medicare)

Ins. Median: $177 (2053% 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 2053% of the Medicare baseline (a markup of 1953%). 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	$6 - $541	70%
UnitedHealthcare	$6 - $535	70%
Blue Shield Epn	$7 - $573	81%
Blue Shield Hmo/Pos	$8 - $644	93%
Aetna	$9	104%
Cencal Mcr Adv - All Other Plans	$9	104%
Tricare	$9	104%
Chn-Community Hlth Ntwrk-All Plans	$10 - $761	116%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$11	128%
Nbd-Ntwrks By Design Non-Exlus	$11 - $919	128%
Ah Employee Health Plan - All Plans	$16	186%
Cencal Mcal	$21 - $1,773	244%
Ccah-Centrl Ca Allince Mcal-All Plans	$24 - $1,798	278%
Nbd-Ntwrks By Design Exlus-All Other Plans	$79 - $768	916%
Blue Shield Epo/Ppo - All Other Plans	$85 - $671	986%
Pacific Health Alliance-All Plans	$123 - $1,432	1427%
Medi-Cal	$137 - $1,555	1589%
Blue Shield Promise Mcal	$177 - $1,869	2053%
Coalinga-All Plans	$178 - $2,068	2065%

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 $15.
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 Twin Cities 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.