CMS Price Transparency Data

Culture, bacterial

Facility: Hialeah Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $19
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 2.20x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Hialeah Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 2.20x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $102 (1183%)
Insurance Median: $19 (220%)
Cash: $102 (1183% of Medicare)
Ins. Median: $19 (220% 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 220% of the Medicare baseline (a markup of 120%). 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
Aetna $3 - $684 35%
Bc/Bs Myblue Hmo Hix $3 - $117 35%
Bc/Bs Of Fl Blue Select Exchange Non Par $4 - $145 46%
Bc/Bs Of Fl Health Options Hmo $4 - $126 46%
Bc/Bs Of Fl Miami Dade Blue Select $4 - $145 46%
Bc/Bs Of Fl Network Blue $4 - $136 46%
Bc/Bs Of Fl Ppo $4 - $136 46%
Bc/Bs Of Fl Simplyblue $4 - $126 46%
Cigna $4 - $279 46%
Humana $5 - $435 58%
Medicaid / KanCare $5 58%
UnitedHealthcare $5 - $8 58%
Veterans Administration Mill Bill $6 70%
Avmed Broad Network $7 81%
Devoted Health $8 93%
Leon Health Inc $8 93%
Medicare (plans) $8 - $19 93%
Bristol Hospice- Miami Dade Llc $9 104%
Catholic Hospice $9 104%
Comprehensive Home Health Care Dba Opuscare Of South Florida $9 104%
Employer Direct Healthcare $9 - $11 104%
Hcr Manor Care Services Of Fl $9 104%
Healthsun Health Plans $9 104%
Hospice Other $9 104%
Longevity Health Plan $9 104%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $9 104%
Seasons Hospice And Pallative Care Of Southern Florida Inc $9 104%
Tricare $9 104%
Veterans Administration Vaccn $9 104%
Vitas Healthcare Hospice Corporation Of Fl $9 104%
Vitas Hospice Unit Agreement $9 104%
Bright Health Management Commercial $10 116%
Dimension Health Wc $10 116%
Florida Pace Centers $10 116%
Imagine Health $10 116%
Oscar Health Plan Hix $10 116%
Workers Compensation $10 116%
Self Pay/Uninsured $11 128%
Naphcare Inc $12 139%
Avmed Exchange $15 174%
Bc/Bs Of Fl Phs $15 - $492 174%
Ambetter / Centene $16 186%
Molina Marketplace Program Exchange $16 186%
Auto Insurance $17 197%
Avmed Select Network $18 209%
Dimensions International $18 - $617 209%
Amerihealth Caritas Next Exchange $19 220%
First Health $19 - $646 220%
Dimension Health Ppo $21 - $712 244%
Commercial Non-Contracted $28 - $949 325%
Self Pay - Mcd Pending 100 Percent $28 - $949 325%
Single Case Agreement $28 - $949 325%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals