CMS Price Transparency Data

Culture, bacterial

Facility: Arthur G James Cancer Hospital and Research Institute

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $55
Cash Discount Price: Unavailable
vs. Medicare Baseline: 6.38x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Arthur G James Cancer Hospital and Research Institute is $55. 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 6.38x the Medicare baseline. Located in 460 W 10Th Ave, Columbus, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $55 (638%)

Ins. Median: $55 (638% 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 638% of the Medicare baseline (a markup of 538%). 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
Healthspan	$21 - $5,413	244%
Humana	$21 - $5,521	244%
Medicare (plans)	$21 - $5,467	244%
Medigold	$21	244%
Upper Ohio Valley	$21 - $5,413	244%
Medicaid / KanCare	$24 - $33	278%
Aetna	$25 - $5,388	290%
United	$26 - $86	302%
Caresource	$31 - $46	360%
Mmo	$31 - $79	360%
Molina	$31 - $5,388	360%
Odrc	$33 - $38	383%
Amerihealth	$35 - $51	406%
Blue Cross Blue Shield	$35 - $89	406%
Buckeye Community	$35 - $46	406%
Osu Health Plan	$43 - $62	499%
Cigna	$58 - $68	673%
Lifetrac	$61 - $64	708%
Ohio Ppo	$62	719%
Ohiohealth	$68 - $69	789%
Frontpath	$75	870%
Healthsmart	$85	986%
Multiplan	$87	1009%
Ohio Dept Of Health	$4,289	49756%

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 $X.
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 Arthur G James Cancer Hospital and Research Institute 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.