CMS Price Transparency Data

Culture, bacterial

Facility: Atrium Health Cleveland

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $171
Cash Discount Price: $171
vs. Medicare Baseline: 19.84x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Atrium Health Cleveland is $171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 19.84x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$171

Average discount available for prompt cash payment at this facility.

Insurance Median

$171

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: $171 (1984%)

Insurance Median: $171 (1984%)

Cash: $171 (1984% of Medicare)

Ins. Median: $171 (1984% 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 1984% of the Medicare baseline (a markup of 1884%). 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 - $263	104%
Cigna	$9 - $273	104%
Humana	$9	104%
UnitedHealthcare	$9 - $182	104%
Alliance	$11 - $57	128%
Amerihealth Caritas	$11 - $48	128%
Carolina Complete Health	$11 - $49	128%
Healthy Blue	$11 - $49	128%
Partners	$11 - $48	128%
Trillium	$11 - $51	128%
Vaya	$11 - $50	128%
Wellcare	$11 - $49	128%
Blue Cross Blue Shield	$106 - $140	1230%
Ambetter / Centene	$109 - $124	1265%
Employers Health Network	$151 - $181	1752%
Physician Reach Out	$171	1984%
Medcost	$190 - $226	2204%
Magellan	$205	2378%
Gmmi	$222	2575%
Quik Trip	$222	2575%
Carolina Behavioral Health	$246 - $273	2854%
Healthgram	$273	3167%
Choicecare	$280	3248%
First Health	$290	3364%
Lifesynch Community Choice Care	$290	3364%
Private Health Care Systems	$307	3561%
Beechstreet	$314	3643%
Multiplan	$324	3759%

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 $171.
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 Atrium Health Cleveland 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.