CMS Price Transparency Data

Culture, bacterial

Facility: Crystal Clinic Orthopaedic Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $116
Cash Discount Price: $59
vs. Medicare Baseline: 13.46x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Crystal Clinic Orthopaedic Center is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 13.46x the Medicare baseline. Located in 444 North Main Street, Akron, OH.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $59 (684%)

Insurance Median: $116 (1346%)

Cash: $59 (684% of Medicare)

Ins. Median: $116 (1346% 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 1346% of the Medicare baseline (a markup of 1246%). 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
Bc Mcr Adv	$9	104%
Summacare Mcr Adv	$9	104%
UnitedHealthcare	$9 - $166	104%
The Health Plan - All Plans	$17	197%
Aultcare - All Plans	$25	290%
Health Oh Network - All Plans	$47	545%
Ohio Health Choice - All Plans	$47	545%
Med Mutual Nas	$49	568%
Multiplan - All Plans	$52	603%
Healthsmart - All Plans	$67	777%
Bc Pathway	$99	1148%
Cigna	$133	1543%
Bc Ohi/Ohii	$136	1578%
Summacare Comm - All Other Plans	$146	1694%
Med Mutual Medflex	$148	1717%
Bc Blue Access	$151	1752%
Bc Preferred	$151	1752%
Bc Trad - All Other Plans	$151	1752%
Med Mutual Aca	$168	1949%
Med Mutual Ppo/Pos/Hmo - All Other Plans	$185	2146%
Aetna	$187	2169%

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 $59.
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 Crystal Clinic Orthopaedic Center 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.