CMS Price Transparency Data

Culture, bacterial

Facility: Boston Children's Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $102
Cash Discount Price: $144
vs. Medicare Baseline: 11.83x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Boston Children's Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $144. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 11.83x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$144

Average discount available for prompt cash payment at this facility.

Insurance Median

$102

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: $144 (1671%)

Insurance Median: $102 (1183%)

Cash: $144 (1671% of Medicare)

Ins. Median: $102 (1183% 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 1183% of the Medicare baseline (a markup of 1083%). 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
Blue Cross Blue Shield	$31 - $95	360%
Unicare	$34	394%
Cdphp	$71 - $122	824%
Harvard Pilgrim	$73 - $97	847%
Aetna	$86 - $121	998%
United	$86 - $120	998%
Mgb/Allways	$88 - $106	1021%
Tufts Public Plan	$88 - $89	1021%
Ambetter / Centene	$91	1056%
United Ri Nj Ny	$91	1056%
Carelon Strategies/Bhs	$94	1090%
UnitedHealthcare	$94 - $122	1090%
Carelon/Beacon	$108	1253%
Fallon	$110 - $111	1276%
Health New England	$116	1346%
Cigna	$122 - $130	1415%
Ets/Lifetrac	$122	1415%
Interlink Transplant	$122	1415%
Community Health Options	$130	1508%
Humana	$130	1508%
Coventry/Hcvm/First Health	$132	1531%
Multiplan/Phcs	$132 - $137	1531%

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 $144.
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 Boston Children's 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.