CMS Price Transparency Data

Culture, bacterial

Facility: Intermountain Health St Vincent Regional Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $31
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.60x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Intermountain Health St Vincent Regional Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 3.60x the Medicare baseline. Located in 1233 N 30Th St, Billings, MT.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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%)

Insurance Median: $31 (360%)

Ins. Median: $31 (360% 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 360% of the Medicare baseline (a markup of 260%). 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
Medicare (plans)	$9	104%
UnitedHealthcare	$9 - $37	104%
Ebms-Employee Benefit Mng	$14 - $35	162%
Sibanye Stillwater Health Partners	$16	186%
Coastal Administrative Services	$17	197%
Exchange Other	$20 - $27	232%
Mt Health Co-Op	$20 - $27	232%
First Choice Health	$21 - $36	244%
Other	$21 - $36	244%
Allegiance	$22 - $37	255%
Pacific Steel And Recycling	$22	255%
Pacificsource	$22 - $37	255%
Blue Cross Blue Shield	$23 - $69	267%
Cigna	$25 - $37	290%
Meritain Health	$25 - $31	290%
Aetna	$26	302%
Preferred One	$34 - $38	394%
Interwest	$36 - $37	418%
Private Hlthcare Sys	$36 - $37	418%
Geha	$37	429%

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 $X.
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 Intermountain Health St Vincent Regional 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.