CMS Price Transparency Data

Culture, bacterial

Facility: St Louis Childrens Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $58
Cash Discount Price: $49
vs. Medicare Baseline: 6.73x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at St Louis Childrens Hospital is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 6.73x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

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: $49 (568%)

Insurance Median: $58 (673%)

Cash: $49 (568% of Medicare)

Ins. Median: $58 (673% 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 673% of the Medicare baseline (a markup of 573%). 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
Aetna	$9 - $64	104%
Blue Cross Blue Shield	$9 - $69	104%
Cox Health [757]	$9	104%
Essence Healthcare [221]	$9	104%
Humana	$9 - $60	104%
Medica [662]	$9	104%
UnitedHealthcare	$9 - $60	104%
Healthscope Benefits [258]	$10 - $65	116%
Healthlink [225]	$39 - $61	452%
Cigna	$40 - $44	464%
Apwu Health Plan [216]	$44	510%
Consociate [478]	$44	510%
Nalc Health Benefit Plan [242]	$44	510%
Priority Health [648]	$44	510%
Sarah Bush Lincoln [636]	$44	510%
Allied Benefits [498]	$47 - $64	545%
Hope Trust [806]	$47	545%
Cox Health Systems Insurance Company [220]	$53 - $60	615%
Med-Pay [480]	$53 - $61	615%
Unicare [568]	$53 - $61	615%
Health Alliance [224]	$57	661%
First Health Commercial [734]	$60	696%
Beechstreet [551]	$61	708%
Detego Health [868]	$61	708%
Health Systems Inc [620]	$61	708%
Healthcare Sol Mercy [609]	$61	708%
Multiplan Commercial [737]	$61	708%
Multiplan [240]	$61	708%
Phcs [244]	$61 - $65	708%
Preferred Health Professionals [561]	$61	708%
Coresource [497]	$64	742%
Fmh Benefit Service Inc [222]	$64	742%
Mail Handlers [495]	$64	742%
Medica [661]	$65	754%
Hfn [563]	$69	800%

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 $49.
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 St Louis Childrens 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.