CMS Price Transparency Data

Culture, bacterial

Facility: Fairview Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $35
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 4.06x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Fairview Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 4.06x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $62 (719%)
Insurance Median: $35 (406%)
Cash: $62 (719% of Medicare)
Ins. Median: $35 (406% 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 406% of the Medicare baseline (a markup of 306%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $8 - $70 93%
Bmchnp $8 - $9 93%
Capital District Physicians' Health Plan $8 - $83 93%
Health New England $8 - $64 93%
Medicaid / KanCare $8 93%
Medicare (plans) $8 - $35 93%
Point32Health $8 - $88 93%
Fallon $9 - $41 104%
Hospice $9 - $36 104%
Other Government $9 - $36 104%
UnitedHealthcare $9 - $79 104%
Blue Cross Blue Shield $10 - $79 116%
Commcare Alliance $10 - $35 116%
Comm Fallon Qhp $13 - $57 151%
Allways Nhp $18 - $60 209%
Unicare $18 - $60 209%
Workers Comp $18 - $59 209%
Comm Hne Hmo $19 - $69 220%
Comm Hne Ppo $20 - $69 232%
Cigna $26 - $86 302%
First Health $26 - $88 302%
Mvp $26 - $83 302%
Oxford $26 - $83 302%
Connecticare $27 - $88 313%
Consolidated Health Plans $27 - $88 313%
Other Commercial $27 - $88 313%
Phcs $27 - $88 313%
Self Pay $27 - $88 313%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 29 Lewis Avenue, Great Barrington, MA 01230
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals