CMS Price Transparency Data

Culture, bacterial

Facility: High Point Regional Health System

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $89
Cash Discount Price: $112
vs. Medicare Baseline: 10.32x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at High Point Regional Health System is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 10.32x the Medicare baseline. Located in 601 N Elm St, High Point, NC.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $112 (1299%)

Insurance Median: $89 (1032%)

Cash: $112 (1299% of Medicare)

Ins. Median: $89 (1032% 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 1032% of the Medicare baseline (a markup of 932%). 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
Alliance	$16	186%
Amerihealth	$16 - $37	186%
Carolina Complete	$16	186%
Healthy Blue	$16	186%
Partners	$16	186%
Trillium	$16	186%
UnitedHealthcare	$16 - $150	186%
Vaya	$16	186%
Wellcare	$16	186%
Ambetter / Centene	$41	476%
Blue Cross Blue Shield	$42 - $68	487%
Medcost	$60 - $144	696%
Aetna	$67 - $146	777%
Oscar	$67 - $90	777%
Cigna	$123	1427%
Directnet	$132	1531%
Private Healthcare Systems	$184	2135%
Multiplan	$202	2343%
Humana	$208 - $213	2413%

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 $112.
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 High Point Regional Health System 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.