CMS Price Transparency Data

Culture, bacterial

Facility: Metropolitan Hospital Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $27
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 3.13x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Metropolitan Hospital Center is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 3.13x the Medicare baseline. Located in 1901 First Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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%)
Insurance Median: $27 (313%)
Ins. Median: $27 (313% 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 313% of the Medicare baseline (a markup of 213%). 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 $6 - $25 70%
Healthfirst $7 - $60 81%
Elderplan $9 104%
Fidelis $9 - $60 104%
Magnacare $10 116%
Oscar $13 151%
Oxford $13 151%
United $13 - $33 151%
Centerlight $18 209%
Cigna $21 244%
Wellcare $22 255%
Carelon $23 - $27 267%
Emblem $25 - $36 290%
Metroplus $26 - $60 302%
Affinity $27 - $60 313%
Amidacare $27 313%
Blue Cross Blue Shield $27 - $60 313%
Carelon (Amida Care) $27 313%
Senior Whole Health $27 313%
United Behavioral Health $27 - $29 313%
Vnsny $27 - $31 313%
Multiplan $29 336%
Local 1199 $31 360%
Villagecare Max $31 360%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 First Avenue, New York, NY 10029
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals