CMS Price Transparency Data

Culture, bacterial

Facility: Loma Linda University Children's Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $61
Cash Discount Price: $73
vs. Medicare Baseline: 7.08x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Loma Linda University Children's Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 7.08x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $73 (847%)

Insurance Median: $61 (708%)

Cash: $73 (847% of Medicare)

Ins. Median: $61 (708% 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 708% of the Medicare baseline (a markup of 608%). 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
UnitedHealthcare	$7	81%
Alpha Care Medical Group	$9 - $13	104%
Dignity Health	$9 - $13	104%
Epic Health Plan	$9 - $156	104%
Inland Empire Health Plan (Iehp)	$9 - $13	104%
Kaiser Foundation Hospitals	$9 - $260	104%
Upland Medical Group	$9	104%
Vantage Medical Group	$9 - $13	104%
Molina Healthcare Of Ca	$11 - $12	128%
Heritage Provider Network	$14	162%
Adventist Health	$15 - $78	174%
Lluh Dept Of Risk Management	$18 - $94	209%
Blue Shield Of California	$34 - $62	394%
Global Benefits Group	$46 - $234	534%
Temecula Valley Physicians Medical Group	$46 - $55	534%
Cigna	$49 - $68	568%
Networks By Design	$49 - $254	568%
Aetna	$50 - $60	580%
Multiplan	$61 - $312	708%
Galaxy Health	$65 - $332	754%
Prime Health Services	$65 - $332	754%
Blue Cross Blue Shield	$85	986%
Trivalley Medical Group	$225	2610%

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 $73.
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 Loma Linda University Children's Hospital 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.