CMS Price Transparency Data

Culture, bacterial

Facility: Wilkes Regional Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $40
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 4.64x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Wilkes Regional Medical Center is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 4.64x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $39 (452%)
Insurance Median: $40 (464%)
Cash: $39 (452% of Medicare)
Ins. Median: $40 (464% 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 464% of the Medicare baseline (a markup of 364%). 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
Healthteam $9 104%
Alliance $16 186%
Amerihealth $16 - $45 186%
Carolina Complete $16 186%
Healthblue $16 186%
Partners $16 186%
Trillium $16 186%
UnitedHealthcare $16 - $42 186%
Vaya $16 186%
Wellcare $16 186%
Medcost $22 - $56 255%
Aetna $30 - $54 348%
Blue Cross Blue Shield $30 - $46 348%
Ambetter / Centene $37 - $48 429%
Cigna $41 - $42 476%
Oscar $43 - $51 499%
Directnet $46 534%
Private Healthcare Systems $70 812%
Multiplan $72 835%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1370 West D St, North Wilkesboro, NC 28659
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals