CMS Price Transparency Data

Culture, bacterial

Facility: North Carolina Baptist Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $60
  • Cash Discount Price: $89
  • vs. Medicare Baseline: 6.96x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at North Carolina Baptist Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 6.96x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$89

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $89 (1032%)
Insurance Median: $60 (696%)
Cash: $89 (1032% of Medicare)
Ins. Median: $60 (696% 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 696% of the Medicare baseline (a markup of 596%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 - $156 104%
Apex $9 104%
Blue Cross Blue Shield $9 - $68 104%
Cigna $9 - $110 104%
Devoted $9 104%
Healthteam $9 104%
Humana $9 - $100 104%
Medicare (plans) $9 104%
UnitedHealthcare $9 - $63 104%
Wellcare $9 - $16 104%
Liberty $10 116%
Medcost $15 - $122 174%
Alliance $16 186%
Amerihealth $16 - $43 186%
Carolina Complete $16 186%
Health Blue $16 186%
Partners $16 186%
Trillium $16 186%
Vaya $16 186%
Ambetter / Centene $39 - $41 452%
Oscar $52 - $66 603%
Directnet $102 - $108 1183%
Cone Health $121 - $128 1404%
Healthgram $121 - $128 1404%
First Carolina Care $138 - $146 1601%
Private Healthcare Systems $142 - $150 1647%
Multiplan $156 - $165 1810%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals