CMS Price Transparency Data

Culture, bacterial

Facility: Athur M Blank Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $218
Cash Discount Price: $311
vs. Medicare Baseline: 25.29x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Athur M Blank Hospital is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $311. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 25.29x the Medicare baseline. Located in 2220 North Druid Hills Road Ne, Atlanta, GA.

Cash / Self-Pay

$311

Average discount available for prompt cash payment at this facility.

Insurance Median

$218

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: $311 (3608%)

Insurance Median: $218 (2529%)

Cash: $311 (3608% of Medicare)

Ins. Median: $218 (2529% 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 2529% of the Medicare baseline (a markup of 2429%). 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
Caresource [61]	$12	139%
Peachstate [43]	$12	139%
Amerigroup [102]	$14	162%
Blue Cross Blue Shield	$82 - $425	951%
Cigna	$82 - $288	951%
United [5]	$82 - $289	951%
Aetna	$83 - $293	963%
Ambetter / Centene	$83 - $291	963%
Oscar [228]	$83 - $291	963%
Caresource Marketplace Bronze/Silver/Gold [60]	$84 - $296	974%
Kaiser [6]	$84 - $296	974%
Sidecar Health [236]	$86 - $300	998%
Coventry [9]	$87 - $305	1009%
Direct Employer Agreements [72]	$87 - $370	1009%
First Health [74]	$93 - $327	1079%
Northeast Georgia Heatlh System [808]	$93 - $326	1079%
Veracity Benefits [809]	$93 - $326	1079%
Phcs [93]	$105 - $370	1218%
Secure Health [340]	$105 - $370	1218%
Beech Street [71]	$112 - $392	1299%
Multiplan [92]	$122 - $426	1415%
Novanet [41]	$124 - $435	1439%

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 $311.
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 Athur M Blank 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.