CMS Price Transparency Data

Culture, bacterial

Facility: Saint Clare's Hospital/ Denville Campus

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $9
  • Cash Discount Price: $8
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Saint Clare's Hospital/ Denville Campus is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.04x the Medicare baseline. Located in 25 Pocono Road, Denville, NJ.
Cash / Self-Pay
$8

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $8 (93%)
Insurance Median: $9 (104%)
Cash: $8 (93% of Medicare)
Ins. Median: $9 (104% 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.

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
UnitedHealthcare $5 - $9 58%
Humana $7 81%
Aetna $9 - $18 104%
Ally-Align (Fka Spartan Health Plan) $9 104%
Amerihealth $9 104%
Clover Health $9 104%
Horizon $9 - $14 104%
Medicare (plans) $9 104%
Tricare $9 104%
Wellcare $9 - $12 104%
Wellpoint Amerigroup $9 104%
Fairprice Healthcare Holdings - Fphh $10 116%
Cigna $12 139%
Employer Direct Healthcare $12 139%
Brighton Health Plan Solutions (Fka Magnacare) $13 151%
Coventry $17 197%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 25 Pocono Road, Denville, NJ 07834
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals