CMS Price Transparency Data

Culture, bacterial

Facility: Atrium Health Navicent Peach

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $45
Cash Discount Price: $41
vs. Medicare Baseline: 5.22x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Atrium Health Navicent Peach is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 5.22x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $41 (476%)

Insurance Median: $45 (522%)

Cash: $41 (476% of Medicare)

Ins. Median: $45 (522% 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 522% of the Medicare baseline (a markup of 422%). 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	$11 - $17	128%
Aetna	$17 - $48	197%
Georgia Health Advantage	$17	197%
Humana	$17 - $70	197%
Pruitt Health	$17	197%
UnitedHealthcare	$17 - $52	197%
Care Source	$18	209%
Cigna	$18 - $60	209%
Clover	$18	209%
Eon Health	$18	209%
Securehealth	$22 - $53	255%
Ambetter / Centene	$25 - $42	290%
Alliant	$40	464%
Multiplan	$53 - $66	615%
Novanet	$66	766%
Three Rivers Provider Network	$70	812%
Beechstreet	$76	882%

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 $41.
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 Atrium Health Navicent Peach 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.