CMS Price Transparency Data

Culture, bacterial

Facility: Pender Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $70
  • Cash Discount Price: $51
  • vs. Medicare Baseline: 8.12x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Pender Memorial Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 8.12x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.
Cash / Self-Pay
$51

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $51 (592%)
Insurance Median: $70 (812%)
Cash: $51 (592% of Medicare)
Ins. Median: $70 (812% 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 812% of the Medicare baseline (a markup of 712%). 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
Humana $29 - $97 336%
Aetna $31 - $96 360%
Blue Cross Blue Shield $31 - $81 360%
Cigna $31 - $50 360%
New Hanover Health $31 360%
Pace Of The Southern Piedmont $31 360%
Amerihealth $32 371%
Carolina Complete $32 371%
Nc Department Of Public Safety $32 - $61 371%
Wellcare $32 371%
Ambetter / Centene $43 499%
Liberty Health $43 499%
Caresource North Carolina $45 522%
Plotkin Health $68 789%
UnitedHealthcare $82 951%
Medcost $85 - $95 986%
Employers Choice Network $110 1276%
Three Rivers Provider Network $110 1276%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 507 E Fremont St, Burgaw, NC 28425
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals