CMS Price Transparency Data

Culture, bacterial

Facility: Essentia Health St Mary's Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $59
  • Cash Discount Price: $71
  • vs. Medicare Baseline: 6.84x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Essentia Health St Mary's Medical Center is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 6.84x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$71

Average discount available for prompt cash payment at this facility.

Insurance Median
$59

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: $71 (824%)
Insurance Median: $59 (684%)
Cash: $71 (824% of Medicare)
Ins. Median: $59 (684% 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 684% of the Medicare baseline (a markup of 584%). 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
Advocare/Security Health $9 104%
Blue Cross Blue Shield $9 - $104 104%
Freedom Blue Ppo $9 104%
Healthpartners Care Msho / Mcr Adv $9 104%
Imcare Msho (Ref Req) $9 104%
Imcare Msho Pcc Prime $9 104%
Imcare Msho Ref Req $9 104%
Itasca Med Care $9 104%
Medica Advantage Solutions $9 104%
Medica Msho/Dual Solutions $9 104%
Medica Prime Solution Group $9 104%
Medicare (plans) $9 104%
Nd Va Administration $9 104%
Platinum Blue / Vantage Blue $9 104%
Primewest $9 104%
Primewest Msho $9 104%
Secure Blue Msho $9 104%
Ubh Cost Plan $9 104%
Ubh Msho $9 104%
Ucare Msho $9 104%
UnitedHealthcare $9 - $100 104%
Medica Access $25 - $45 290%
Sanford Health Plan $28 - $62 325%
Healthpartners Care Pmap $31 - $55 360%
Blue Plus Pmap Pcc Prime $34 - $68 394%
Medica $43 - $78 499%
Medica Uplan $43 - $76 499%
Healthpartners $46 - $98 534%
Medica Choice $47 - $84 545%
Ucare $51 - $90 592%
Cigna $55 - $98 638%
Healthpartners Pcc Prime $55 - $98 638%
Wea $55 - $105 638%
Security Health $59 - $105 684%
America'S Ppo $60 - $106 696%
Wps $64 - $115 742%
Aetna $65 - $116 754%
Healthscope Benefits $65 - $116 754%
Healtheos $66 - $118 766%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals