CMS Price Transparency Data

Culture, bacterial

Facility: Fishermen's Community Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $320
Cash Discount Price: $558
vs. Medicare Baseline: 37.12x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Fishermen's Community Hospital is $320. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $558. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 37.12x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.

Cash / Self-Pay

$558

Average discount available for prompt cash payment at this facility.

Insurance Median

$320

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: $558 (6473%)

Insurance Median: $320 (3712%)

Cash: $558 (6473% of Medicare)

Ins. Median: $320 (3712% 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 3712% of the Medicare baseline (a markup of 3612%). 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
Aetna	$5 - $676	58%
Amerigroup	$5	58%
Medicaid / KanCare	$5 - $6	58%
Sunshine State	$5	58%
UnitedHealthcare	$5 - $882	58%
Vista	$5	58%
Wellcare	$5	58%
Blue Cross Blue Shield	$66 - $882	766%
Leon Medical	$83 - $185	963%
Medica Health Plan	$83 - $185	963%
Medicare (plans)	$83 - $250	963%
Humana	$90 - $202	1044%
Avmed	$91 - $730	1056%
Cigna	$95 - $706	1102%
Non Contracted	$145 - $324	1682%
International	$257 - $573	2981%
Amerihealth	$296 - $662	3434%
Dimension Health Plan	$296 - $794	3434%
Affordable	$356 - $794	4130%
Phcs	$356 - $794	4130%
Quality Health	$356 - $794	4130%

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 $558.
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 Fishermen's Community 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.