CMS Price Transparency Data

Culture, bacterial

Facility: Adventist Health Howard Memorial

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $174
Cash Discount Price: $77
vs. Medicare Baseline: 20.19x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Adventist Health Howard Memorial is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 20.19x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$174

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: $77 (893%)

Insurance Median: $174 (2019%)

Cash: $77 (893% of Medicare)

Ins. Median: $174 (2019% 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 2019% of the Medicare baseline (a markup of 1919%). 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%
Blue Shield Mcare	$41 - $79	476%
Medicare (plans)	$41 - $80	476%
Tricare	$41 - $79	476%
UnitedHealthcare	$45 - $306	522%
Blue Cross Blue Shield	$86 - $103	998%
Ah Employee Health Plan - All Plans	$107 - $205	1241%
Aetna	$138 - $265	1601%
Blue Shield - All Other Plans	$140 - $271	1624%
Blue Shield Epn	$140 - $270	1624%
Western Growers/Pinnacle - All Plans	$154 - $296	1787%
First Health Ppo - All Plans	$164 - $316	1903%
Ghn Ppo - All Plans	$164 - $316	1903%
Healthnet - All Plans	$168 - $324	1949%
Brms - All Plans	$174 - $336	2019%
Cigna	$174 - $336	2019%

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 $77.
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 Howard Memorial 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.