CMS Price Transparency Data

Culture, bacterial

Facility: Kenmore Mercy Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $9
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Kenmore Mercy Hospital is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.04x the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.
Cash / Self-Pay
$16

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: $16 (186%)
Insurance Median: $9 (104%)
Cash: $16 (186% 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
Iha First Choice [800001] $7 81%
Independent Health [100165] $7 - $9 81%
Independent Health Essential [100166] $8 93%
UnitedHealthcare $8 - $10 93%
Crime Victims [100176] $8 93%
Univera Healthcare Essential [100170] $8 - $10 93%
Excellus Rochester McD [350117] $8 93%
Medicaid / KanCare $8 - $9 93%
Tuscarora Nation [550120] $8 93%
Beacon Essential [350122] $8 93%
VA Veterans Affairs [700001] $9 104%
Humana $9 104%
Wellcare Fidelis Dual [450451] $9 104%
Aetna $9 104%
Hospice [550001] $9 104%
Univera Healthcare [100169] $9 - $13 104%
Seneca Nation [450119] $9 104%
Fallon Health [450115] $9 104%
Federal Workers Compensation [500100] $9 104%
Fidelis Dual Advantage [450120] $9 104%
Tricare $9 104%
Champ VA [700002] $9 104%
Blue Cross Blue Shield $9 - $19 104%
Catholic Health Life Pace [400005] $9 104%
Cigna $9 104%
Wellcare [450129] $9 104%
Medicare (plans) $9 104%
Covid19 Hrsa [45013] $9 104%
Fidelis Exchange [100164] $13 151%
Amerigroup [350102] $17 197%
No Fault [114001] $18 209%
Fidelis Essential [100163] $19 220%
Molina Essential [100167] $19 220%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2950 Elmwood Avenue, Kenmore, NY 14217
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals