CMS Price Transparency Data

Culture, bacterial

Facility: UW Health

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $190
Cash Discount Price: $73
vs. Medicare Baseline: 22.04x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at UW Health is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 22.04x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $73 (847%)

Insurance Median: $190 (2204%)

Cash: $73 (847% of Medicare)

Ins. Median: $190 (2204% 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 2204% of the Medicare baseline (a markup of 2104%). 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
Aetna	$9 - $286	104%
Blue Cross Blue Shield	$9 - $196	104%
Humana	$9	104%
Medicare (plans)	$9	104%
Mychoice Wi Medical Adv	$9	104%
UnitedHealthcare	$9 - $14	104%
Quartz Fully Insured	$11	128%
Quartz Aso	$12	139%
Ecoh	$17 - $312	197%
Hfn	$17 - $312	197%
Alliance Premier Network	$111 - $216	1288%
The Alliance	$143 - $278	1659%
Wps Ppo	$158 - $306	1833%
Cigna	$163 - $316	1891%
Beloit Healt System	$184 - $357	2135%
Mercycare	$190 - $370	2204%
First Health/Coventry	$200 - $389	2320%
Health Payment Systems	$238 - $462	2761%
Healthsmart	$238 - $462	2761%
Sheboygan Employers Health Network	$254 - $493	2947%
Multiplan	$283 - $551	3283%

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 $73.
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 UW Health 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.