CMS Price Transparency Data

Culture, bacterial

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $15
Cash Discount Price: $107
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at UMass Memorial Health - Harrington Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.74x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$107

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $107 (1241%)

Insurance Median: $15 (174%)

Cash: $107 (1241% of Medicare)

Ins. Median: $15 (174% 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
Masshealth [20302]	$8	93%
Medicaid / KanCare	$8 - $9	93%
Aetna	$9 - $107	104%
Blue Cross Blue Shield	$9 - $28	104%
Cigna	$9 - $76	104%
Commonwealth Care Alliance [10103]	$9	104%
Fallon Mcr Supp [20202]	$9	104%
Fallon Mcr [10105]	$9	104%
Institution [10406]	$9	104%
Mgb Mcr [10124]	$9	104%
Senior Whole Health [10110]	$9	104%
Tufts Mcr [10112]	$9	104%
Tufts Us Family [11203]	$9	104%
UnitedHealthcare	$9 - $107	104%
Champva [11001]	$10	116%
Workers Compensation [20501]	$12	139%
Tufts Connectorcare [10507]	$15	174%
Wellpoint [11112]	$23	267%
Harvard Pilgrim [10701]	$32 - $39	371%
Fallon Connectorcare [10503]	$68	789%
Hne [11108]	$70	812%
Tufts [11201]	$76	882%
First Health Network [11120]	$80	928%
Evernorth Behavioral Health [27]	$86	998%
Connecticare [11105]	$107	1241%
Fallon Carelon Hlth [28]	$107	1241%
Fallon Mcaid Carelon Hlth [29]	$107	1241%
Grants [20507]	$107	1241%
Masshealth Mcd Mbhp [38]	$107	1241%
Wellsense Mcaid Carelon Hlth [21]	$107	1241%
Hsno/Free Care [10801]	$681	7900%

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 $107.
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 UMass Memorial Health - Harrington 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.