CMS Price Transparency Data

Culture, bacterial

Facility: Novant Health Medical Park Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $102
Cash Discount Price: $90
vs. Medicare Baseline: 11.83x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Novant Health Medical Park Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 11.83x the Medicare baseline. Located in 1950 S Hawthorne Rd, Winston-Salem, NC.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$102

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: $90 (1044%)

Insurance Median: $102 (1183%)

Cash: $90 (1044% of Medicare)

Ins. Median: $102 (1183% 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 1183% of the Medicare baseline (a markup of 1083%). 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 - $249	104%
Blue Cross Blue Shield	$9 - $224	104%
Cigna	$9 - $185	104%
Humana	$9 - $242	104%
Liberty Health	$9	104%
Pace Of The Southern Piedmont	$9	104%
UnitedHealthcare	$9 - $209	104%
Nc Department Of Public Safety	$17 - $74	197%
Amerihealth	$27 - $75	313%
Carolina Complete	$27 - $74	313%
Wellcare	$27 - $75	313%
Caresource North Carolina	$45 - $124	522%
Atlantic Corporation Dba Atlantic Packaging	$64 - $176	742%
Plotkin Health	$68 - $187	789%
Amps	$73 - $202	847%
Medcost	$96 - $292	1114%
Primary Physician Care	$99 - $274	1148%
Beechstreet	$102 - $280	1183%
Multiplan	$102 - $280	1183%
Phcs	$102 - $280	1183%
Employers Choice Network	$110 - $302	1276%
Three Rivers Provider Network	$110 - $302	1276%

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 $90.
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 Medical Park Hospital 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.