CMS Price Transparency Data

Culture, bacterial

Facility: Ira Davenport Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $131
Cash Discount Price: $43
vs. Medicare Baseline: 15.20x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Ira Davenport Memorial Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 15.20x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $43 (499%)

Insurance Median: $131 (1520%)

Cash: $43 (499% of Medicare)

Ins. Median: $131 (1520% 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 1520% of the Medicare baseline (a markup of 1420%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Empire	$4	46%
Amerihealth Caritas Mcr Adv - All Plans	$9	104%
Blue Cross Blue Shield	$9 - $626	104%
Fidelis	$9	104%
Humana	$9 - $186	104%
Tricare	$9	104%
UnitedHealthcare	$18 - $217	209%
Fidelis Care - Exchange - All Plans	$113	1311%
Geisinger - All Plans	$120	1392%
Cigna	$129	1497%
Mvp Health Plan - All Plans	$129	1497%
Independent Health - All Plans	$134	1555%
Upmc - All Plans	$142	1647%
Pomco Inc - All Plans	$149	1729%
Aetna	$155 - $184	1798%
Emblem Health - All Plans	$182	2111%
Emblem/Ghi	$191	2216%
Martins Point - All Plans	$206	2390%
Healthnow - All Plans	$679	7877%

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 $43.
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 Ira Davenport Memorial 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.