CMS Price Transparency Data

Culture, bacterial

Facility: Novant Health Thomasville Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $123
Cash Discount Price: $117
vs. Medicare Baseline: 14.27x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Novant Health Thomasville Medical Center is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 14.27x the Medicare baseline. Located in 207 Old Lexington Rd Box 789, Thomasville, NC.

Cash / Self-Pay

$117

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $117 (1357%)

Insurance Median: $123 (1427%)

Cash: $117 (1357% of Medicare)

Ins. Median: $123 (1427% 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 1427% of the Medicare baseline (a markup of 1327%). 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 - $181	104%
Blue Cross Blue Shield	$9 - $163	104%
Cigna	$9 - $138	104%
Humana	$9 - $176	104%
Liberty Health	$9	104%
Pace Of The Southern Piedmont	$9	104%
UnitedHealthcare	$9 - $152	104%
Nc Department Of Public Safety	$17 - $41	197%
Carolina Complete	$25 - $41	290%
Amerihealth	$26 - $42	302%
Wellcare	$26 - $42	302%
Caresource North Carolina	$56 - $90	650%
Atlantic Corporation Dba Atlantic Packaging	$79 - $128	916%
Plotkin Health	$83 - $136	963%
Amps	$90 - $147	1044%
Medcost	$118 - $212	1369%
Primary Physician Care	$122 - $199	1415%
Multiplan	$125 - $203	1450%
Phcs	$125 - $203	1450%
Employers Choice Network	$135 - $219	1566%
Three Rivers Provider Network	$135 - $219	1566%

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 $117.
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 Novant Health Thomasville Medical Center 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.