CMS Price Transparency Data
Culture, bacterial
Facility: Mercy Health Saint Mary's
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $60
- Cash Discount Price: $56
- vs. Medicare Baseline: 6.96x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercy Health Saint Mary's is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 6.96x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$56
Average discount available for prompt cash payment at this facility.
Insurance Median
$60
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: $56 (650%)
Insurance Median: $60 (696%)
Cash: $56 (650% of Medicare)
Ins. Median: $60 (696% 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 696% of the Medicare baseline (a markup of 596%). 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 | $5 - $130 | 58% |
| Medicaid / KanCare | $5 - $76 | 58% |
| Access Health | $6 | 70% |
| Aetna | $8 - $130 | 93% |
| Blue Care Network Advantage | $8 - $130 | 93% |
| Medicare (plans) | $8 - $130 | 93% |
| Align Senior Care | $9 - $133 | 104% |
| Correctional Recovery | $9 | 104% |
| Hospice Faith | $9 | 104% |
| Hospice Of Holland | $9 | 104% |
| Oscar | $9 | 104% |
| UnitedHealthcare | $9 - $137 | 104% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $10 - $150 | 116% |
| U Of M Health Plan | $10 - $65 | 116% |
| Bcn Domestic | $11 | 128% |
| Blue Benefit Administrators Of Massachusetts | $11 | 128% |
| Blue Care Network | $11 | 128% |
| Blue Distinction Transplant | $11 | 128% |
| Blue Shield - Ca | $11 | 128% |
| Blue Shield - Id (Regence) | $11 | 128% |
| Blue Shield - Ny Highmark Northeastern | $11 | 128% |
| Blue Shield - Ny Highmark Western | $11 | 128% |
| Blue Shield - Pa (Highmark) | $11 | 128% |
| Blue Shield - Wa (Regence) | $11 | 128% |
| Health Choices | $11 - $65 | 128% |
| Kaiser Domestic | $11 | 128% |
| Molina Marketplace | $11 | 128% |
| Geha | $13 - $65 | 151% |
| Medical Mutual | $13 | 151% |
| Meritain | $13 | 151% |
| Preferred One | $13 | 151% |
| Vitalcore | $13 - $206 | 151% |
| Wellpath | $13 | 151% |
| Wc Accident Fund | $43 - $47 | 499% |
| Wc Advantage | $43 - $47 | 499% |
| Wc Aig | $43 - $47 | 499% |
| Wc Allied | $43 - $47 | 499% |
| Wc Amerisure | $43 - $47 | 499% |
| Wc Amtrust | $43 - $47 | 499% |
| Wc Asu Risk Mgt | $43 - $47 | 499% |
| Wc Berkley Admin | $43 - $47 | 499% |
| Wc Broadspire | $43 - $47 | 499% |
| Wc Bunch & Associates | $43 - $47 | 499% |
| Wc Ccmsi | $43 - $47 | 499% |
| Wc Emc Insurance Company | $43 - $47 | 499% |
| Wc Esis | $43 - $47 | 499% |
| Wc Fcci | $43 - $47 | 499% |
| Wc Federated | $43 - $47 | 499% |
| Wc Gallagher Bassett | $43 - $47 | 499% |
| Wc Genex Care For Ohio | $43 - $47 | 499% |
| Wc Guard Insurance Company | $43 - $47 | 499% |
| Wc Hartford | $43 - $47 | 499% |
| Wc Liberty Mutual | $43 - $47 | 499% |
| Wc Meijers | $43 - $47 | 499% |
| Wc Michigan | $43 - $47 | 499% |
| Wc Mitchell Frankenmuth | $43 - $47 | 499% |
| Wc Pma | $43 - $47 | 499% |
| Wc Sedgwick | $43 - $47 | 499% |
| Wc Sentry | $43 - $47 | 499% |
| Wc Travelers | $43 - $47 | 499% |
| Wc Tristar | $43 - $47 | 499% |
| Wc Walmart | $43 - $47 | 499% |
| Wc Zurich | $43 - $47 | 499% |
| Nomi Health | $44 - $48 | 510% |
| Acs Benefit Services | $45 - $49 | 522% |
| Allied Benefit Systems | $45 - $49 | 522% |
| Claimchoice Adminstrators | $45 - $49 | 522% |
| Consociate | $45 - $49 | 522% |
| Cypress Benefit Administrators | $45 - $49 | 522% |
| Forest County Potawatomi | $45 - $49 | 522% |
| Health Smart | $45 - $49 | 522% |
| Healthgram | $45 - $49 | 522% |
| Healthscope | $45 - $49 | 522% |
| Secureone Preferred United Plans | $45 - $49 | 522% |
| Sisco Benefits | $45 - $49 | 522% |
| The Health Plan | $45 - $49 | 522% |
| Trustmark Small Business Benefits | $45 - $49 | 522% |
| Unified Group Services | $45 - $49 | 522% |
| Webtpa | $45 - $49 | 522% |
| Asr Health Benefits | $50 - $55 | 580% |
| Hap | $50 - $67 | 580% |
| Varipro | $51 - $56 | 592% |
| Caresource | $52 - $56 | 603% |
| Priority Health | $52 - $53 | 603% |
| 1199 National Benefit Fund | $58 - $63 | 673% |
| Allied National Global Care | $58 - $63 | 673% |
| Asrm - Reliance Standard Life Insurance | $58 - $63 | 673% |
| Christian Care Ministry | $58 - $63 | 673% |
| Cigna | $58 - $63 | 673% |
| Dean Health | $58 - $63 | 673% |
| Fallon Health | $58 - $63 | 673% |
| Family Life Insurance Company | $58 - $63 | 673% |
| Ghc Scw | $58 - $63 | 673% |
| Group Pension Administrators | $58 - $63 | 673% |
| International Benefit Administrators | $58 - $63 | 673% |
| Lifetime Benefit Solutions | $58 - $63 | 673% |
| Manhattan Life | $58 - $63 | 673% |
| Medi Share | $58 - $63 | 673% |
| Multiplan | $58 - $63 | 673% |
| Mvp | $58 - $63 | 673% |
| Pai | $58 - $63 | 673% |
| Pan-American Life | $58 - $63 | 673% |
| Paramount Hmo | $58 - $63 | 673% |
| Phcs | $58 - $63 | 673% |
| Trinity Health Share | $58 - $63 | 673% |
| Acclaim | $60 - $65 | 696% |
| Administrative Concepts | $60 - $65 | 696% |
| Allegeant | $60 - $65 | 696% |
| Ameriben | $60 - $65 | 696% |
| American Family | $60 - $65 | 696% |
| American Healthcare Alliance | $60 - $65 | 696% |
| American Republic | $60 - $65 | 696% |
| Amerihealth | $60 - $65 | 696% |
| Aultcare | $60 - $65 | 696% |
| Automated Benefit Services | $60 - $65 | 696% |
| Auxiant | $60 - $65 | 696% |
| Benefit Administrative Systems,Llc | $60 - $65 | 696% |
| Boon Chapman | $60 - $65 | 696% |
| Cam Administrative Services | $60 - $65 | 696% |
| Christian Brother Services | $60 - $65 | 696% |
| Christian Brothers Holy Cross | $60 - $65 | 696% |
| Comprehensive Benefits | $60 - $65 | 696% |
| Continental Life Insurance | $60 - $65 | 696% |
| Custom Benefit Administrators | $60 - $65 | 696% |
| Employee Benefit Concepts | $60 - $65 | 696% |
| Employee Benefit Management | $60 - $65 | 696% |
| Enterprise Group Planning | $60 - $65 | 696% |
| Freedom Life Insurance Company | $60 - $65 | 696% |
| Group Administrators | $60 - $65 | 696% |
| Group Marketing Services | $60 - $65 | 696% |
| Guardian | $60 - $65 | 696% |
| Health America | $60 - $65 | 696% |
| Healthez | $60 - $65 | 696% |
| Humana | $60 - $86 | 696% |
| Insight | $60 - $65 | 696% |
| Intercare | $60 - $65 | 696% |
| Jfp Benefit Management | $60 - $65 | 696% |
| Jp Farley Corporation | $60 - $65 | 696% |
| Key Benefit Administrator | $60 - $65 | 696% |
| Liberty Union Life Assurance Co | $60 - $65 | 696% |
| Lucent Health | $60 - $65 | 696% |
| Luminare Health | $60 - $65 | 696% |
| Luminare Health (Detroit) | $60 - $65 | 696% |
| Medben | $60 - $65 | 696% |
| Medcost | $60 - $65 | 696% |
| Mutual Health Services | $60 - $65 | 696% |
| Mutual Of Omaha | $60 - $65 | 696% |
| Ncas | $60 - $65 | 696% |
| Nippon Life Ins | $60 - $65 | 696% |
| Nova | $60 - $65 | 696% |
| Painters Union Insurance Fund | $60 - $65 | 696% |
| Physicians Mutual | $60 - $65 | 696% |
| Plumbers Local 98 Insurance Fund | $60 - $65 | 696% |
| Prairie States | $60 - $65 | 696% |
| Primary Physician Care | $60 - $65 | 696% |
| Professional Benefit Administrators | $60 - $65 | 696% |
| The Loomis Company | $60 - $65 | 696% |
| Unicare | $60 - $65 | 696% |
| Us Health And Life | $60 - $65 | 696% |
| Valenz | $60 - $65 | 696% |
| Western & Southern Financial Group | $60 - $65 | 696% |
| Wps | $60 - $65 | 696% |
| Coventry | $63 - $68 | 731% |
| First Health | $63 - $68 | 731% |
| Cmh Allegan County | $79 - $86 | 916% |
| Cmh Ausable Valley | $79 - $86 | 916% |
| Cmh Barry County | $79 - $86 | 916% |
| Cmh Berrien County | $79 - $86 | 916% |
| Cmh Cass County | $79 - $86 | 916% |
| Cmh Clinton-Eaton-Ingham County | $79 - $86 | 916% |
| Cmh Kalamazoo | $79 - $86 | 916% |
| Cmh Kent County | $79 - $86 | 916% |
| Cmh Lenawee County | $79 - $86 | 916% |
| Cmh Misc | $79 - $86 | 916% |
| Cmh Monroe County | $79 - $86 | 916% |
| Cmh Montcalm County | $79 - $86 | 916% |
| Cmh Muskegon County | $79 - $86 | 916% |
| Cmh Newaygo County | $79 - $86 | 916% |
| Cmh North Country | $79 - $86 | 916% |
| Cmh Northern Lakes County | $79 - $86 | 916% |
| Cmh Ottawa County | $79 - $86 | 916% |
| Cmh Van Buren County | $79 - $86 | 916% |
| Cmh West Mi County | $79 - $86 | 916% |
| Magellan Behavioral Health | $79 - $86 | 916% |