CMS Price Transparency Data

Culture, bacterial

Facility: Clinch Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $61
Cash Discount Price: $32
vs. Medicare Baseline: 7.08x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Clinch Memorial Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 7.08x the Medicare baseline. Located in 1050 Valdosta Highway, Homerville, GA.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $32 (371%)

Insurance Median: $61 (708%)

Cash: $32 (371% of Medicare)

Ins. Median: $61 (708% 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 708% of the Medicare baseline (a markup of 608%). 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	$42 - $84	487%
UnitedHealthcare	$44 - $70	510%
Amerigroup	$45 - $84	522%
Caresource	$45 - $84	522%
Cigna	$45 - $71	522%
Peach State Health Plan	$45 - $84	522%
Blue Cross Blue Shield	$46 - $72	534%
Novanet	$48 - $76	557%
Alliant	$50 - $84	580%
Devoted	$50 - $84	580%
Eon Health	$50 - $84	580%
Humana	$50 - $84	580%
Wellcare	$50 - $84	580%
Clover	$53 - $84	615%

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 $32.
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 Clinch Memorial 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.