CMS Price Transparency Data

Culture, bacterial

Facility: West Valley Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $147
Cash Discount Price: $216
vs. Medicare Baseline: 17.05x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at West Valley Medical Center is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 17.05x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$216

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $216 (2506%)

Insurance Median: $147 (1705%)

Cash: $216 (2506% of Medicare)

Ins. Median: $147 (1705% 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 1705% of the Medicare baseline (a markup of 1605%). 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	$7 - $905	81%
Molina	$7 - $9	81%
Select Health Idaho (Eirmc Only)	$8 - $133	93%
Humana	$9 - $351	104%
Regence Blue Shield	$9	104%
St Luke'S Health Partners	$9	104%
United	$9 - $250	104%
Veteran'S Administration	$9	104%
Corizon Health	$10 - $155	116%
True Blue	$10 - $165	116%
Cigna	$14 - $234	162%
Pacificsource Health	$15 - $250	174%
Moda	$16 - $260	186%
Regence	$18	209%
Aetna	$20 - $331	232%
Four Rivers Hospice	$21 - $334	244%
Multiplan	$21 - $334	244%
Geha Ppo Usa	$22 - $355	255%
Coventry First Health	$23 - $376	267%
St Alphonsus Health	$23 - $376	267%

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 $216.
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 West Valley Medical Center 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.