CMS Price Transparency Data

Culture, bacterial

Facility: Shriners Hospital for Children

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $12
Cash Discount Price: $74
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Shriners Hospital for Children is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.39x the Medicare baseline. Located in 2211 North Oak Park Ave, Chicago, IL.

Cash / Self-Pay

$74

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $74 (858%)

Insurance Median: $12 (139%)

Cash: $74 (858% of Medicare)

Ins. Median: $12 (139% 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.

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
Soonercare	$8	93%
Aetna	$9	104%
Ambetter / Centene	$9 - $10	104%
Cigna	$9	104%
Providence Health Plan	$10	116%
Blue Cross Blue Shield	$11 - $17	128%
Sana Benefits	$12	139%
UnitedHealthcare	$12	139%
Loyola University Medical Center	$13	151%
Healthlink	$15	174%

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 $74.
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 Shriners Hospital for Children 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.