CMS Price Transparency Data
Culture, bacterial
Facility: St Catherine of Siena Hospital
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $9
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at St Catherine of Siena Hospital is $9. 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 1.04x the Medicare baseline. Located in 50 Route 25A, Smithtown, NY.
Cash / Self-Pay
Unavailable
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%)
Insurance Median: $9 (104%)
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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Affinity Health Plan | $8 - $19 | 93% |
| Beacon Health Options | $8 - $6,747 | 93% |
| Beacon Health Strategies | $8 - $12 | 93% |
| Blue Cross Blue Shield | $8 - $32 | 93% |
| Centerlight Healthcare | $8 - $9 | 93% |
| Elderplan Inc. | $8 - $9 | 93% |
| Emblem Health | $8 - $19 | 93% |
| Fidelis Care New York | $8 - $19 | 93% |
| Health First | $8 - $19 | 93% |
| Health Plus | $8 - $19 | 93% |
| Independent Health | $8 - $9 | 93% |
| Medicaid / KanCare | $8 | 93% |
| Mvp Health Plans | $8 - $22 | 93% |
| Senior Whole Health | $8 - $9 | 93% |
| UnitedHealthcare | $8 - $32 | 93% |
| Aetna | $9 - $12 | 104% |
| Agewell New York | $9 | 104% |
| Centers Plan For Healthy Living | $9 | 104% |
| Healthspring | $9 | 104% |
| Humana | $9 | 104% |
| Liberty Health | $9 | 104% |
| Longevity Health Plan | $9 | 104% |
| Medicare (plans) | $9 | 104% |
| Orthonet - Uniformed Services Family Health Plan | $9 | 104% |
| Partners Health Plan | $9 | 104% |
| Pmc | $9 | 104% |
| Surest | $9 | 104% |
| Tricare | $9 | 104% |
| Universal Healthcare | $9 | 104% |
| Us Family Health Plan | $9 | 104% |
| Veterans Affairs | $9 | 104% |
| Wellcare Health Plan Inc | $9 | 104% |
| Zadroga | $11 | 128% |
| Mail Handlers Benefit Plan | $12 | 139% |
| Meritain Health | $12 | 139% |
| Nippon Life Insurance Company Of America | $12 | 139% |
| Salvation Army | $12 | 139% |
| Centivo | $13 - $22 | 151% |
| American Plan Administrators | $19 | 220% |
| Amerihealth Administrators | $19 | 220% |
| Benefit Services | $19 | 220% |
| Ghi Cbp Ny City Employee Alternate | $19 | 220% |
| International Benefit Administrator | $19 | 220% |
| Ultra Benefits Inc. | $19 | 220% |
| Apwu | $22 | 255% |
| Brighton | $22 - $214 | 255% |
| Cigna | $22 - $199 | 255% |
| Daniel H Cook | $22 | 255% |
| Nalc | $22 | 255% |
| Samba | $22 | 255% |
| Self Pay | $32 | 371% |
| Local 1199 | $48 | 557% |
| Oscar Health | $125 | 1450% |
| Allied Wellfare Fund | $199 | 2309% |
| American Group Administrators | $199 | 2309% |
| Bakery & Confectionery Union | $199 | 2309% |
| Comprehensive Benefits Consultant | $199 | 2309% |
| Guardian Life Insurance Company Of America | $199 | 2309% |
| Maloney And Assoc | $199 | 2309% |
| Multiplan | $199 | 2309% |
| Performax | $199 | 2309% |
| Phcs | $199 | 2309% |
| Pomco | $199 | 2309% |
| Tpa Inc | $199 | 2309% |
| Unicare | $199 | 2309% |
| United Employees Health Plan | $199 | 2309% |
| Coventry | $226 - $245 | 2622% |
| Magellan | $245 | 2842% |
| Galaxy | $275 | 3190% |
| Three Rivers Provider Network | $275 | 3190% |
| Aither Health | $306 | 3550% |
| Alpha Care | $306 | 3550% |
| Dentaquest | $306 | 3550% |