CMS Price Transparency Data

Culture, bacterial

Facility: Atlantic Rehabilitation Institute, LLC

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $115
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 13.34x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Atlantic Rehabilitation Institute, LLC is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 13.34x the Medicare baseline. Located in 200 Madison Ave, Madison, NJ.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$115

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: $115 (1334%)
Insurance Median: $115 (1334%)
Cash: $115 (1334% of Medicare)
Ins. Median: $115 (1334% 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 1334% of the Medicare baseline (a markup of 1234%). 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
Aetna $18 - $219 209%
All Savers Cpd $18 - $219 209%
Ama Insurance Msg $18 - $219 209%
Ambetter / Centene $18 - $219 209%
Amerigroup Mgg (Wellpoint As Of 5/1/24) $18 - $219 209%
Amerihealth Cpd $18 - $219 209%
Amerihealth Mgg $18 - $219 209%
Blue Cross Blue Shield $18 - $219 209%
Braven Health Cpd $18 - $219 209%
Braven Health Mgd $18 - $219 209%
Cigna $18 - $219 209%
Claim Doc Llc Cpd $18 - $219 209%
First Managed Care Wc Cpd $18 - $219 209%
Gateway Mgg $18 - $219 209%
Medicaid / KanCare $18 - $219 209%
Oscar Health Cpd $18 - $219 209%
Oxford Health Plan Cpd $18 - $219 209%
Oxford Mgg $18 - $219 209%
Qualcare Cpd $18 - $219 209%
Qualcare Lynx Wc Cpd $18 - $219 209%
UnitedHealthcare $18 - $219 209%
Upmc For Life Mgg $18 - $219 209%
Wellcare Mgg $18 - $219 209%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Madison Ave, Madison, NJ 07940
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL