CMS Price Transparency Data
Culture, bacterial
Facility: Trinity Health Oakland Hospital
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $69
- Cash Discount Price: $73
- vs. Medicare Baseline: 8.00x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Trinity Health Oakland Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 8.00x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$73
Average discount available for prompt cash payment at this facility.
Insurance Median
$69
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: $73 (847%)
Insurance Median: $69 (800%)
Cash: $73 (847% of Medicare)
Ins. Median: $69 (800% 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 800% of the Medicare baseline (a markup of 700%). 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.
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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 | $5 - $9 | 58% |
| Medicaid / KanCare | $5 | 58% |
| Aetna | $8 - $51 | 93% |
| Blue Care Network Advantage | $8 | 93% |
| Medicare (plans) | $8 - $9 | 93% |
| Align Senior Care | $9 | 104% |
| Bcn Domestic | $9 | 104% |
| Blue Benefit Administrators Of Massachusetts | $9 | 104% |
| Blue Care Network | $9 | 104% |
| Blue Distinction Transplant | $9 | 104% |
| Blue Shield - Ca | $9 | 104% |
| Blue Shield - Id (Regence) | $9 | 104% |
| Blue Shield - Ny Highmark Northeastern | $9 | 104% |
| Blue Shield - Ny Highmark Western | $9 | 104% |
| Blue Shield - Pa (Highmark) | $9 | 104% |
| Blue Shield - Wa (Regence) | $9 | 104% |
| Cca - Zing Health | $9 | 104% |
| Health Choices | $9 - $83 | 104% |
| Hospice Advantage | $9 | 104% |
| Kaiser Domestic | $9 | 104% |
| UnitedHealthcare | $9 - $85 | 104% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $10 | 116% |
| U Of M Health Plan | $10 | 116% |
| Molina Marketplace | $11 | 128% |
| Geha | $13 - $85 | 151% |
| Health Cost Solutions | $13 | 151% |
| Medical Mutual | $13 | 151% |
| Meritain | $13 | 151% |
| Priority Health | $13 - $14 | 151% |
| Vitalcore | $13 | 151% |
| Wellpath | $13 | 151% |
| Employee Benefit Logistic | $19 | 220% |
| Asr Health Benefits | $29 | 336% |
| Caresource | $29 | 336% |
| Hap | $29 - $82 | 336% |
| Varipro | $29 | 336% |
| Wc Accident Fund | $31 - $34 | 360% |
| Wc Advantage | $31 - $34 | 360% |
| Wc Aig | $31 - $34 | 360% |
| Wc Allied | $31 - $34 | 360% |
| Wc Amerisure | $31 - $34 | 360% |
| Wc Amtrust | $31 - $34 | 360% |
| Wc Asu Risk Mgt | $31 - $34 | 360% |
| Wc Berkley Admin | $31 - $34 | 360% |
| Wc Broadspire | $31 - $34 | 360% |
| Wc Bunch & Associates | $31 - $34 | 360% |
| Wc Ccmsi | $31 - $34 | 360% |
| Wc Emc Insurance Company | $31 - $34 | 360% |
| Wc Esis | $31 - $34 | 360% |
| Wc Fcci | $31 - $34 | 360% |
| Wc Federated | $31 - $34 | 360% |
| Wc Gallagher Bassett | $31 - $34 | 360% |
| Wc Genex Care For Ohio | $31 - $34 | 360% |
| Wc Guard Insurance Company | $31 - $34 | 360% |
| Wc Hartford | $31 - $34 | 360% |
| Wc Liberty Mutual | $31 - $34 | 360% |
| Wc Meijers | $31 - $34 | 360% |
| Wc Michigan | $31 - $34 | 360% |
| Wc Mitchell Frankenmuth | $31 - $34 | 360% |
| Wc Pma | $31 - $34 | 360% |
| Wc Sedgwick | $31 - $34 | 360% |
| Wc Sentry | $31 - $34 | 360% |
| Wc Travelers | $31 - $34 | 360% |
| Wc Tristar | $31 - $34 | 360% |
| Wc Walmart | $31 - $34 | 360% |
| Wc Zurich | $31 - $34 | 360% |
| Acs Benefit Services | $44 - $50 | 510% |
| Allied Benefit Systems | $44 - $50 | 510% |
| Claimchoice Adminstrators | $44 - $50 | 510% |
| Consociate | $44 - $50 | 510% |
| Cypress Benefit Administrators | $44 - $50 | 510% |
| Forest County Potawatomi | $44 - $50 | 510% |
| Health Smart | $44 - $50 | 510% |
| Healthgram | $44 - $50 | 510% |
| Healthscope | $44 - $50 | 510% |
| Secureone Preferred United Plans | $44 - $50 | 510% |
| Sisco Benefits | $44 - $50 | 510% |
| The Health Plan | $44 - $50 | 510% |
| Trustmark Small Business Benefits | $44 - $50 | 510% |
| Unified Group Services | $44 - $50 | 510% |
| Webtpa | $44 - $50 | 510% |
| Mclaren Health | $49 - $59 | 568% |
| Carelon Behavioral Health | $50 - $56 | 580% |
| Magellan Behavioral Health | $61 - $68 | 708% |
| 1199 National Benefit Fund | $69 - $77 | 800% |
| Allied National Global Care | $69 - $77 | 800% |
| Asrm - Reliance Standard Life Insurance | $69 - $77 | 800% |
| Christian Care Ministry | $69 - $77 | 800% |
| Dean Health | $69 - $77 | 800% |
| Fallon Health | $69 - $77 | 800% |
| Family Life Insurance Company | $69 - $77 | 800% |
| Ghc Scw | $69 - $77 | 800% |
| Group Pension Administrators | $69 - $77 | 800% |
| International Benefit Administrators | $69 - $77 | 800% |
| Lifetime Benefit Solutions | $69 - $77 | 800% |
| Manhattan Life | $69 - $77 | 800% |
| Medi Share | $69 - $77 | 800% |
| Multiplan | $69 - $77 | 800% |
| Mvp | $69 - $77 | 800% |
| Pai | $69 - $77 | 800% |
| Pan-American Life | $69 - $77 | 800% |
| Paramount Hmo | $69 - $77 | 800% |
| Phcs | $69 - $77 | 800% |
| Trinity Health Share | $69 - $77 | 800% |
| Access Health | $74 - $83 | 858% |
| Acclaim | $74 - $83 | 858% |
| Administrative Concepts | $74 - $83 | 858% |
| Allegeant | $74 - $83 | 858% |
| Ameriben | $74 - $83 | 858% |
| American Family | $74 - $83 | 858% |
| American Healthcare Alliance | $74 - $83 | 858% |
| American National | $74 - $83 | 858% |
| American Republic | $74 - $83 | 858% |
| Amerihealth | $74 - $83 | 858% |
| Aultcare | $74 - $83 | 858% |
| Automated Benefit Services | $74 - $83 | 858% |
| Auxiant | $74 - $83 | 858% |
| Benefit Administrative Systems,Llc | $74 - $83 | 858% |
| Boon Chapman | $74 - $83 | 858% |
| Cam Administrative Services | $74 - $83 | 858% |
| Christian Brother Services | $74 - $83 | 858% |
| Christian Brothers Holy Cross | $74 - $83 | 858% |
| Comprehensive Benefits | $74 - $83 | 858% |
| Continental Life Insurance | $74 - $83 | 858% |
| Custom Benefit Administrators | $74 - $83 | 858% |
| Employee Benefit Concepts | $74 - $83 | 858% |
| Employee Benefit Management | $74 - $83 | 858% |
| Enterprise Group Planning | $74 - $83 | 858% |
| Freedom Life Insurance Company | $74 - $83 | 858% |
| Group Administrators | $74 - $83 | 858% |
| Group Marketing Services | $74 - $83 | 858% |
| Guardian | $74 - $83 | 858% |
| Health America | $74 - $83 | 858% |
| Health Partners | $74 - $82 | 858% |
| Healthcare Management Admin | $74 - $83 | 858% |
| Healthez | $74 - $83 | 858% |
| Humana | $74 - $83 | 858% |
| Insight | $74 - $83 | 858% |
| Intercare | $74 - $83 | 858% |
| Jfp Benefit Management | $74 - $83 | 858% |
| Jp Farley Corporation | $74 - $83 | 858% |
| Key Benefit Administrator | $74 - $83 | 858% |
| Liberty Union Life Assurance Co | $74 - $83 | 858% |
| Lucent Health | $74 - $83 | 858% |
| Luminare Health | $74 - $83 | 858% |
| Luminare Health (Detroit) | $74 - $83 | 858% |
| Magnacare | $74 - $83 | 858% |
| Medben | $74 - $83 | 858% |
| Medcost | $74 - $83 | 858% |
| Mutual Health Services | $74 - $83 | 858% |
| Mutual Of Omaha | $74 - $83 | 858% |
| Ncas | $74 - $83 | 858% |
| Nippon Life Ins | $74 - $83 | 858% |
| Nova | $74 - $83 | 858% |
| Painters Union Insurance Fund | $74 - $83 | 858% |
| Physicians Mutual | $74 - $83 | 858% |
| Plumbers Local 98 Insurance Fund | $74 - $83 | 858% |
| Prairie States | $74 - $83 | 858% |
| Preferred One | $74 - $83 | 858% |
| Primary Physician Care | $74 - $83 | 858% |
| Professional Benefit Administrators | $74 - $83 | 858% |
| Siho Insurance Services | $74 - $83 | 858% |
| The Loomis Company | $74 - $83 | 858% |
| Tufts Health Plan | $74 - $82 | 858% |
| Unicare | $74 - $83 | 858% |
| Us Health And Life | $74 - $83 | 858% |
| Valenz | $74 - $83 | 858% |
| Western & Southern Financial Group | $74 - $83 | 858% |
| Wps | $74 - $83 | 858% |
| Cigna | $75 - $84 | 870% |
| Coventry | $76 - $85 | 882% |
| First Health | $76 - $85 | 882% |
| Prime Health Services | $81 - $90 | 940% |
| Three Rivers Provider Network | $91 - $102 | 1056% |
| Cmh Detroit Wayne Integrated Health Network | $101 - $113 | 1172% |
| Cmh Lenawee County | $101 - $113 | 1172% |
| Cmh Livingston County | $101 - $113 | 1172% |
| Cmh Misc | $101 - $113 | 1172% |
| Cmh Monroe County | $101 - $113 | 1172% |
| Cmh Oakland County | $101 - $113 | 1172% |
| Cmh Washtenaw County | $101 - $113 | 1172% |