CMS Price Transparency Data

Culture, bacterial

Facility: Licking Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $83
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 9.63x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Licking Memorial Hospital is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 9.63x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$83

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: $114 (1323%)
Insurance Median: $83 (963%)
Cash: $114 (1323% of Medicare)
Ins. Median: $83 (963% 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 963% of the Medicare baseline (a markup of 863%). 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
Tricare $8 93%
Aetna $9 - $90 104%
Blue Cross Blue Shield $9 - $106 104%
Champva [500001] $9 104%
Cigna $9 - $111 104%
Humana $9 - $120 104%
Medicare (plans) $9 104%
UnitedHealthcare $9 - $105 104%
Veterans Administration [100068] $9 104%
Wellcare By Allwell [450104] $9 104%
Molina Marketplace [100106] $14 162%
Medical Mutual [100114] $38 - $103 441%
Medben [700068] $48 - $121 557%
Allied Benefit Systems [100015] $49 - $89 568%
Geha [100039] $49 - $89 568%
Gravie Administrative Services [100165] $49 - $89 568%
Meritain [100063] $49 - $89 568%
Optima [700069] $49 - $89 568%
Trustmark Small Business Benefits [100263] $49 - $89 568%
Webtpa [100127] $49 - $89 568%
Benicomp [70090] $52 - $93 603%
Consociate Health 6 Degrees [100059] $55 - $99 638%
Consociate Health [100029] $55 - $99 638%
Healthscope [100157] $58 - $105 673%
Surest [100016] $58 - $105 673%
United Medical Resources [700071] $58 - $105 673%
American Postal Workers [100089] $62 - $111 719%
Antidote Health Plan Of Ohio [70006803] $62 - $111 719%
Coresource [100002] $62 - $124 719%
Great West Life [700064] $62 - $111 719%
National Association Of Letter Carriers [100067] $62 - $111 719%
Ohio Healthy Luminare Health [100264] $62 - $111 719%
Ohio Healthy [100255] $62 - $111 719%
Ohio Ppo Connect [70006801] $62 - $111 719%
Osu Prime Care [100254] $62 - $111 719%
Quality Care Partners [70006802] $62 - $111 719%
The Health Plan [100261] $62 - $111 719%
Wellfleet Group, Llc [100164] $62 - $111 719%
Coventry [100010] $63 - $114 731%
Pan American Life [700070] $63 - $114 731%
Ohio Health Choice [100109] $66 - $119 766%
Administrative Concepts [100006] $67 - $120 777%
Carefactor [100087] $67 - $120 777%
Philadelphia American Life [100260] $67 - $124 777%
Reliance Standard-Asrm [100258] $67 - $120 777%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals