CMS Price Transparency Data

Culture, bacterial

Facility: Mt Sinai Hospital Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $16
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mt Sinai Hospital Medical Center is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.86x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $20 (232%)
Insurance Median: $16 (186%)
Cash: $20 (232% of Medicare)
Ins. Median: $16 (186% 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.

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
Oscar - All Plans $2 - $72 23%
Lawndale Christian - All Plans $4 - $9 46%
Blue Cross Blue Shield $8 - $42 93%
Cigna $8 - $81 93%
Tricare $8 93%
Va Healthnet - All Plans $8 93%
Advocate Physician Prtnrs - All Other Plans $9 104%
Advocate Physician Prtnrs Mcr $9 104%
Ambetter / Centene $9 - $69 104%
Cenpatico Illinicare Dual $9 104%
Cenpatico Illinicare Mcr - All Other Plans $9 104%
Harmony Behavioral Htlh - All Plans $9 104%
Humana $9 - $207 104%
Meridian/Harmony D-Snp - All Plans $9 104%
Molina Mcr - All Other Plans $9 104%
Nextlevel Hlth Icp Fhp Aca - All Plans $9 104%
Partners In Hlth - All Plans $9 - $26 104%
UnitedHealthcare $9 104%
Zing Mcr Adv - All Plans $9 104%
Aetna $11 - $149 128%
Family Health Network Mcaid - All Plans $11 128%
Healthlink Hmo $11 - $33 128%
Healthlink Ppo - All Other Plans $11 - $33 128%
Molina Mcaid $11 128%
Compsych Ip/Op Only - All Plans $13 - $40 151%
Hfn Platinum $14 - $43 162%
Multiplan Primary Ntwrk/Phcs - All Other Plans $15 - $46 174%
Hfn Epo $17 - $53 197%
Multiplan Complementary Ntwrk $17 - $53 197%
Hfn Ppo - All Other Plans $19 - $58 220%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals