CMS Price Transparency Data

Culture, bacterial

Facility: Mayers Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $103
Cash Discount Price: $120
vs. Medicare Baseline: 11.95x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Mayers Memorial Hospital is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 11.95x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$120

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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: $120 (1392%)

Insurance Median: $103 (1195%)

Cash: $120 (1392% of Medicare)

Ins. Median: $103 (1195% 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 1195% of the Medicare baseline (a markup of 1095%). 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
Medi-Cal	$10	116%
Partnership Hp-All Plans	$10	116%
Blue Shield Ca Va	$75	870%
Blue Shield Mcr Adv	$75	870%
Arcadian Health Services-All Plans	$79	916%
Health Net Mcr Adv	$79	916%
Tricare	$79	916%
Blue Cross Blue Shield	$80 - $103	928%
Health Net Prison	$86	998%
Imperial Health Plan-All Plans	$90	1044%
Blue Shield Ca Exchange	$103	1195%
Blue Shield-All Other Plans	$114	1323%
Cigna	$114	1323%
Corvel Ppo-All Plans	$114	1323%
Coventry/First Health-All Plans	$114	1323%
Hmn-All Plans	$114	1323%
Integrated Hp-All Plans	$114	1323%
Interplan-All Plans	$114	1323%
Multiplan Phcs-All Plans	$114	1323%
Pfmc-All Plans	$114	1323%
Superior Ca-All Plans	$114	1323%
Health Net-All Other Plans	$119	1381%
Pacificare-All Plans	$120	1392%

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 $120.
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 Mayers Memorial 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.