CMS Price Transparency Data

Culture, bacterial

Facility: North Adams Regional Hospital Corporation

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $30
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 3.48x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at North Adams Regional Hospital Corporation is $30. 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 3.48x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $30 (348%)
Cash: $62 (719% of Medicare)
Ins. Median: $30 (348% 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 348% of the Medicare baseline (a markup of 248%). 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
Blue Cross Blue Shield $6 - $79 70%
Mcrmanaged Cca One Care $6 - $21 70%
Medicare (plans) $6 - $21 70%
Comm Hospice $7 - $21 81%
Mcr Miscellaneous $7 - $21 81%
Mcrmanaged Usa Family $7 - $21 81%
Mcrmanaged Va $7 - $21 81%
Medicaid / KanCare $7 - $41 81%
Oth United Vaccn $7 - $21 81%
Mcd Masshealth $8 93%
Mcd New York $8 93%
Mcd Out Of State $8 93%
Mcdmanaged Bmchnp $8 - $9 93%
Mcdmanaged Cdphp $8 93%
Mcdmanaged Hne Mcdaco $8 93%
Mcdmanaged Network $8 - $52 93%
Aetna $10 - $70 116%
Tricare $10 - $35 116%
Comm Fallon Qhp $13 - $52 151%
Comm Network Qhpsub $16 - $56 186%
Wc Workers Comp $17 - $56 197%
Comm Network Qhpnonsub $18 - $66 209%
Comm Nhp $18 - $60 209%
Comm Unicare $18 - $60 209%
Comm Hne $19 - $64 220%
Comm Hne Hmo $19 - $69 220%
Comm Hne Ppo $20 - $69 232%
Comm Tufts $23 - $73 267%
UnitedHealthcare $24 - $79 278%
Cigna $26 - $86 302%
Comm Cdphp $26 - $83 302%
Comm First Health $26 - $88 302%
Comm Mvp $26 - $83 302%
Comm Oxford $26 - $83 302%
Comm Connecticare $27 - $88 313%
Comm Consolidated Health $27 - $88 313%
Comm Harvard $27 - $88 313%
Comm Other $27 - $88 313%
Comm Phcs $27 - $88 313%
Comm Self Pay $27 - $88 313%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals