CMS Price Transparency Data

Culture, bacterial

Facility: Lutheran Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $23
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 2.67x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Lutheran Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 2.67x the Medicare baseline. Located in 1730 West 25Th Street, Cleveland, OH.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $36 (418%)
Insurance Median: $23 (267%)
Cash: $36 (418% of Medicare)
Ins. Median: $23 (267% 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 267% of the Medicare baseline (a markup of 167%). 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 $9 - $56 104%
Cigna $9 - $45 104%
Communicare $9 104%
Devoted Health $9 104%
Humana $9 - $48 104%
Mmo $9 - $34 104%
Perennial Health $9 104%
Summacare $9 - $23 104%
The Health Plan $9 - $34 104%
United $9 - $14 104%
UnitedHealthcare $9 - $35 104%
Upmc $9 - $34 104%
Valor $9 104%
Blue Cross Blue Shield $14 - $36 162%
Buckeye $14 162%
Caresource $14 162%
Molina $14 162%
Paramount $14 162%
United Bh $14 162%
Amerihealth $15 174%
Oscar $17 - $22 197%
Zing Health $17 197%
Cc Ehp $22 - $23 255%
Aultcare $24 278%
Amish Community Aid Plan $25 - $28 290%
Ohcp $27 313%
Omas $28 325%
Ohio Healthy $30 348%
Healthsmart $31 360%
Php $34 394%
Phphi $34 394%
Gms $39 452%
Medical Benefit Corp $39 452%
Quality Care Partners $39 452%
Consociate Health $42 487%
Frontpath $50 580%
Managed Care Services $50 580%
Multiplan $50 580%
Tertiary Care Network $50 580%
Three Rivers $50 580%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1730 West 25Th Street, Cleveland, OH 44113
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals