CMS Price Transparency Data

Culture, bacterial

Facility: Connecticut Childrens Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $27
Cash Discount Price: $22
vs. Medicare Baseline: 3.13x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Connecticut Childrens Medical Center is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 3.13x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$22

Average discount available for prompt cash payment at this facility.

Insurance Median

$27

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: $22 (255%)

Insurance Median: $27 (313%)

Cash: $22 (255% of Medicare)

Ins. Median: $27 (313% 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 313% of the Medicare baseline (a markup of 213%). 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
Blue Cross Blue Shield	$10 - $27	116%
Golden Rule [100106]	$10 - $30	116%
Harvard Pilgrim [1001134]	$10 - $30	116%
Oxford [100103]	$10 - $30	116%
UnitedHealthcare	$10 - $30	116%
Aetna	$11 - $30	128%
Connecticare [100105]	$11 - $19	128%
Emblem Health Commercial [1001108]	$11 - $19	128%
Medicaid / KanCare	$11 - $19	128%
1199 National Benefit Fund [100134]	$12 - $30	139%
Government Employees Hospital Assoc [100115]	$12 - $30	139%
Humana	$12 - $30	139%
Meritain Health [100149]	$12 - $30	139%
Nippon Life Ins Co Of America [100112]	$12 - $30	139%
Yale Health Plan [100162]	$12 - $30	139%
Unicare [100148]	$14 - $27	162%
Wellpoint [100150]	$14 - $27	162%
Multiplan [1001126]	$26 - $31	302%
Cigna	$29 - $31	336%
Great West Healthcare [100107]	$29 - $31	336%
Health Partners [110229]	$29 - $31	336%
Mvp Health Plan [100144]	$29 - $31	336%
Tufts Health Plan [100114]	$29 - $31	336%
Cdphp/Comm [100199]	$31	360%
Generic Multiplan [1001130]	$31	360%
Ultrabenefits/Comm [100181]	$31	360%

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 $22.
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 Connecticut Childrens Medical Center 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.