CMS Price Transparency Data

Culture, bacterial

Facility: Saint Joseph Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $147
Cash Discount Price: Unavailable
vs. Medicare Baseline: 17.05x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Saint Joseph Hospital is $147. 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 17.05x the Medicare baseline. Located in 1375 E 19Th Ave, Denver, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $147 (1705%)

Ins. Median: $147 (1705% 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 1705% of the Medicare baseline (a markup of 1605%). 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
Cigna	$6 - $368	70%
Geha	$9 - $214	104%
Select Health	$9	104%
UnitedHealthcare	$9 - $214	104%
Blue Cross Blue Shield	$15 - $300	174%
Denv Hlth Med Plan	$22	255%
Kaiser Perm Hmo	$50 - $155	580%
Kaiser Self Funded	$62 - $155	719%
Kaiser Perm Ppo/Pos	$63 - $160	731%
Allegiance	$68 - $92	789%
Kaiser Mrp	$68 - $92	789%
Kaiser Snp	$68 - $92	789%
Aetna	$101 - $330	1172%
Preferred One	$108 - $147	1253%
Humana	$114 - $155	1323%
Cofinity	$196 - $265	2274%
First Health Network	$196 - $265	2274%
Private Hlthcare Sys	$204 - $276	2367%
Multiplan Inc	$228 - $309	2645%
Midlands Choice	$263 - $357	3051%

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 $X.
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 Saint Joseph 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.