CMS Price Transparency Data

Culture, bacterial

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $23
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 2.67x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Atrium Health Navicent Rehabilitation Hopsital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 2.67x the Medicare baseline. Located in 3351 Northside Dr, Macon, GA.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $40 (464%)
Insurance Median: $23 (267%)
Cash: $40 (464% of Medicare)
Ins. Median: $23 (267% 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 267% of the Medicare baseline (a markup of 167%). 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
UnitedHealthcare $5 - $31 58%
Aetna $9 - $55 104%
Alliant $9 - $10 104%
Blue Cross Blue Shield $9 - $11 104%
Care Source $9 104%
Clover $9 104%
Eon Health $9 104%
Georgia Health Advantage $9 104%
Humana $9 - $54 104%
Pruitt Health $9 104%
Cigna $12 - $23 139%
Kaiser $12 - $30 139%
Ibg $22 - $56 255%
Securehealth $22 - $28 255%
Ambetter / Centene $24 - $40 278%
Multiplan $51 - $63 592%
Novanet $63 731%
Three Rivers Provider Network $67 777%
Beechstreet $73 847%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3351 Northside Dr, Macon, GA 31210
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL