CMS Price Transparency Data

Culture, bacterial

Facility: Fairview Bethesda Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $43
Cash Discount Price: $28
vs. Medicare Baseline: 4.99x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Fairview Bethesda Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 4.99x the Medicare baseline. Located in 45 10Th St W, Saint Paul, MN.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $28 (325%)

Insurance Median: $43 (499%)

Cash: $28 (325% of Medicare)

Ins. Median: $43 (499% 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 499% of the Medicare baseline (a markup of 399%). 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	$6 - $53	70%
Health Partners	$6 - $71	70%
Itasca Medical Care	$8 - $9	93%
Medica	$8 - $66	93%
Primewest	$8 - $9	93%
Sanford Health Plan	$8 - $53	93%
Security Health Plan	$8 - $68	93%
South Country Health Alliance	$8 - $9	93%
UnitedHealthcare	$8 - $52	93%
Wellcare	$8	93%
Hennepin Health	$9 - $10	104%
Ucare	$9 - $38	104%
America'S Ppo	$12 - $65	139%
First Health	$20 - $74	232%
Multiplan	$20 - $77	232%
Private Healthcare Systems	$20 - $77	232%
Wisconsin Physician Services	$22 - $82	255%

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 $28.
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 Fairview Bethesda 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.