CMS Price Transparency Data

Culture, bacterial

Facility: Wakemed, Raleigh Campus

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $34
Cash Discount Price: $58
vs. Medicare Baseline: 3.94x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Wakemed, Raleigh Campus is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 3.94x the Medicare baseline. Located in 3000 New Bern Ave, Raleigh, NC.

Cash / Self-Pay

$58

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $58 (673%)

Insurance Median: $34 (394%)

Cash: $58 (673% of Medicare)

Ins. Median: $34 (394% 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 394% of the Medicare baseline (a markup of 294%). 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
Amerihealth	$4 - $53	46%
Carolina Complete	$4 - $53	46%
Wellcare	$4 - $53	46%
Blue Cross Blue Shield	$6 - $148	70%
Cigna	$6 - $152	70%
First Health	$6 - $262	70%
Aetna	$8 - $203	93%
Alignment	$9	104%
Ambetter / Centene	$9 - $108	104%
Liberty	$9	104%
Pruitt	$9	104%
Medcost	$17 - $224	197%
Phcs	$19 - $238	220%
Multiplan	$22 - $268	255%

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 $58.
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 Wakemed, Raleigh Campus 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.