CMS Price Transparency Data

Culture, bacterial

Facility: Cheshire Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $89
Cash Discount Price: $43
vs. Medicare Baseline: 10.32x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Cheshire Medical Center is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 10.32x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $43 (499%)

Insurance Median: $89 (1032%)

Cash: $43 (499% of Medicare)

Ins. Median: $89 (1032% 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 1032% of the Medicare baseline (a markup of 932%). 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 Caritas Nh	$8 - $32	93%
Granite State Health Plan	$8 - $43	93%
UnitedHealthcare	$8 - $196	93%
Wellsense Health Plan	$8 - $36	93%
Aetna	$9 - $176	104%
Ambetter / Centene	$9	104%
Blue Cross Blue Shield	$9 - $205	104%
Cigna	$9 - $128	104%
Martin'S Point Generations Advantage	$9	104%
Martin'S Point Health Care	$9	104%
Mvp	$9 - $128	104%
Wellcare Health Plans	$9	104%
Mass General Brigham Health Plan	$11 - $258	128%
Harvard Pilgrim Health Care Of Ne	$13 - $117	151%
Tufts Health Plan	$23 - $165	267%
Maine Community Health Options	$42 - $116	487%
First Health/Hcvm	$79 - $219	916%
Phcs	$84 - $232	974%

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 $43.
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 Cheshire 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.