CMS Price Transparency Data

Culture, bacterial

Facility: Adventist Health Vallejo

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $230
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 26.68x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Adventist Health Vallejo is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 26.68x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$230

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: $78 (905%)
Insurance Median: $230 (2668%)
Cash: $78 (905% of Medicare)
Ins. Median: $230 (2668% 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 2668% of the Medicare baseline (a markup of 2568%). 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
Blue Shield Behav Hlth $3 - $238 35%
Blue Shield Non-Epn-All Other Plans $3 - $245 35%
UnitedHealthcare $3 - $337 35%
Blue Shield Epn $4 - $249 46%
Phcs-All Plans $4 - $290 46%
Western Growers-All Plans $4 - $280 46%
Choicecare-All Plans $5 - $370 58%
Interplan-All Plans $5 - $343 58%
Beech Street-All Plans $6 - $396 70%
Cigna $6 - $422 70%
Health Management Network-All Plans $6 - $449 70%
Kaiser-All Plans $6 - $444 70%
Galaxy Network-All Plans $7 - $475 81%
Three Rivers-All Plans $7 - $475 81%
Medi-Cal $8 - $10 93%
Va Medi-Cal $8 - $10 93%
Blue Shield Mcr Adv $9 104%
Medicare (plans) $9 104%
Napa County Mcal Child $9 104%
Tricare $9 104%
Va Mcr-All Other Plans $9 104%
Ah Employee Health Plan-All Plans $16 186%
Healthnet-All Plans $45 - $46 522%
Aetna $50 580%
Blue Cross Blue Shield $83 - $99 963%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 Oregon St, Vallejo, CA 94590
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Psychiatric