CMS Price Transparency Data

Culture, bacterial

Facility: Valley Children's Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $356
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 41.30x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Valley Children's Hospital is $356. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 41.30x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$356

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%)
Insurance Median: $356 (4130%)
Ins. Median: $356 (4130% 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 4130% of the Medicare baseline (a markup of 4030%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Allcare Ipa $12 139%
Central California Alliance For Health $17 197%
Dignity Ipa_Formerly Img $17 197%
La Salle Ipa $17 197%
Sante Ipa $17 197%
Central Valley Medical Providers Ipa $18 - $324 209%
Kaiser $18 - $421 209%
Sequoia Health Ipa $18 209%
Univseral Healthcare Ipa $18 209%
Community Care Ipa $19 220%
United Physicians Network Ipa $19 220%
Adventist $22 255%
Blue Cross Blue Shield $22 - $85 255%
Cencal Health $24 278%
Kern Family Health Care $24 278%
Health Net $228 - $424 2645%
Dignity Health Central Coast $321 3724%
Community Health $356 4130%
Stanislaus Partners In Health $356 4130%
Physicians Choice Medical Group $362 4200%
Health Plan Of San Joaquin $388 4501%
Fowler Packing $401 4652%
Dignity (Formerly Managed Care Systems) $408 4733%
Kern Legacy $421 4884%
Blue Shield $432 - $491 5012%
Aetna $433 5023%
First Health Formerly Coventry $479 5557%
Bakersfield Family Medical Group $485 5626%
Network By Design $501 5812%
Community Care Health Plan $517 5998%
Health Smart $518 6009%
Key Medical Ipa $518 6009%
Sutter Health $550 6381%
Multiplan $619 7181%
UnitedHealthcare $872 10116%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens