CMS Price Transparency Data

Culture, bacterial

Facility: Crouse Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $11
Cash Discount Price: $24
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Crouse Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.28x the Medicare baseline. Located in 736 Irving Avenue, Syracuse, NY.

Cash / Self-Pay

$24

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

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: $24 (278%)

Insurance Median: $11 (128%)

Cash: $24 (278% of Medicare)

Ins. Median: $11 (128% 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.

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
Excellus	$9 - $19	104%
Brighton Healthplan	$10 - $11	116%
Fidelis	$10 - $22	116%
Healthfirst Health Plan	$10 - $11	116%
Molina	$10 - $22	116%
Mycompass	$10 - $11	116%
UnitedHealthcare	$10 - $17	116%
Wellcare	$10 - $12	116%
Aetna	$11 - $18	128%
Cdphp	$11	128%
Emblemhealth	$11	128%
Humana	$11	128%
Martins Point	$11	128%
Mvp	$11 - $22	128%
Nascentia	$11	128%
Emblem Health	$24	278%

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 $24.
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 Crouse Hospital 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.