CMS Price Transparency Data
Culture, bacterial
Facility: Diley Ridge Medical Center
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $50
- Cash Discount Price: $70
- vs. Medicare Baseline: 5.80x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Diley Ridge Medical Center is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 5.80x the Medicare baseline. Located in 7911 Diley Road, Canal Winchester, OH.
Cash / Self-Pay
$70
Average discount available for prompt cash payment at this facility.
Insurance Median
$50
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: $70 (812%)
Insurance Median: $50 (580%)
Cash: $70 (812% of Medicare)
Ins. Median: $50 (580% 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 580% of the Medicare baseline (a markup of 480%). 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 | $8 - $48 | 93% |
| Blue Cross Blue Shield | $8 - $107 | 93% |
| Medicare (plans) | $8 - $9 | 93% |
| Blue Benefit Administrators Of Massachusetts | $9 | 104% |
| Blue Care Network | $9 | 104% |
| Blue Distinction Transplant | $9 | 104% |
| Blue Shield - Ca | $9 | 104% |
| Blue Shield - Id (Regence) | $9 | 104% |
| Blue Shield - Ny Highmark Northeastern | $9 | 104% |
| Blue Shield - Ny Highmark Western | $9 | 104% |
| Blue Shield - Pa (Highmark) | $9 | 104% |
| Blue Shield - Wa (Regence) | $9 | 104% |
| Hospice Mount Carmel | $9 | 104% |
| Oscar | $9 | 104% |
| The Health Plan | $9 - $70 | 104% |
| UnitedHealthcare | $9 - $55 | 104% |
| Enterprise Group Planning | $17 | 197% |
| Custom Design Benefits | $18 | 209% |
| Quality Care Partners | $19 | 220% |
| American Postal Workers Secondary | $36 | 418% |
| Cigna | $36 | 418% |
| Health Partners | $36 | 418% |
| Healthgram | $36 | 418% |
| Mvp | $36 | 418% |
| Priority Health | $36 | 418% |
| Geha | $48 - $55 | 557% |
| Gravie Admin Services | $48 | 557% |
| Healthez | $48 | 557% |
| Meritain | $48 | 557% |
| Webtpa | $48 | 557% |
| Access Health | $50 | 580% |
| Acclaim | $50 | 580% |
| Administrative Concepts | $50 | 580% |
| Allegeant | $50 | 580% |
| Allied Benefit Systems | $50 | 580% |
| American Family | $50 | 580% |
| American Healthcare Alliance | $50 | 580% |
| American National | $50 | 580% |
| American Republic | $50 | 580% |
| Amerihealth | $50 | 580% |
| Aultcare | $50 | 580% |
| Automated Benefit Services | $50 | 580% |
| Auxiant | $50 | 580% |
| Benefit Administrative Systems,Llc | $50 | 580% |
| Boon Chapman | $50 | 580% |
| Cam Administrative Services | $50 | 580% |
| Christian Brother Services | $50 | 580% |
| Christian Brothers Holy Cross | $50 | 580% |
| Claimchoice Adminstrators | $50 | 580% |
| Comprehensive Benefits | $50 | 580% |
| Continental Life Insurance | $50 | 580% |
| Coventry | $50 | 580% |
| Custom Benefit Administrators | $50 | 580% |
| Cypress Benefit Administrators | $50 | 580% |
| Employee Benefit Concepts | $50 | 580% |
| Employee Benefit Management | $50 | 580% |
| Forest County Potawatomi | $50 | 580% |
| Freedom Life Insurance Company | $50 | 580% |
| Group Administrators | $50 | 580% |
| Group Marketing Services | $50 | 580% |
| Group Pension Administrators | $50 | 580% |
| Guardian | $50 | 580% |
| Health America | $50 | 580% |
| Health Choices | $50 | 580% |
| Healthcare Management Admin | $50 | 580% |
| Insight | $50 | 580% |
| Intercare | $50 | 580% |
| Jfp Benefit Management | $50 | 580% |
| Jp Farley Corporation | $50 | 580% |
| Key Benefit Administrator | $50 | 580% |
| Liberty Union Life Assurance Co | $50 | 580% |
| Lucent Health | $50 | 580% |
| Luminare Health | $50 | 580% |
| Magnacare | $50 | 580% |
| Medcost | $50 | 580% |
| Mutual Health Services | $50 | 580% |
| Mutual Of Omaha | $50 | 580% |
| Ncas | $50 | 580% |
| Nippon Life Ins | $50 | 580% |
| Nova | $50 | 580% |
| Painters Union Insurance Fund | $50 | 580% |
| Physicians Mutual | $50 | 580% |
| Plumbers Local 98 Insurance Fund | $50 | 580% |
| Prairie States | $50 | 580% |
| Preferred One | $50 | 580% |
| Primary Physician Care | $50 | 580% |
| Professional Benefit Administrators | $50 | 580% |
| Secureone Preferred United Plans | $50 | 580% |
| Siho Insurance Services | $50 | 580% |
| Sisco Benefits | $50 | 580% |
| The Loomis Company | $50 | 580% |
| Trustmark Small Business Benefits | $50 | 580% |
| U Of M Health Plan | $50 | 580% |
| Unicare | $50 | 580% |
| Unified Group Services | $50 | 580% |
| Us Health And Life | $50 | 580% |
| Valenz | $50 | 580% |
| Varipro | $50 | 580% |
| Wps | $50 | 580% |
| Medben | $54 - $80 | 626% |
| Humana | $55 - $107 | 638% |
| First Health | $56 | 650% |
| Consociate | $65 | 754% |
| Health Ohio Network | $65 | 754% |
| Caresource | $78 | 905% |
| Healthlink Inc | $80 | 928% |
| Medical Benefits Mutual | $80 | 928% |
| Ohio Health Choice | $80 | 928% |
| Ohio Ppo Connect | $80 | 928% |
| Medical Mutual | $81 | 940% |
| Medi Share | $85 | 986% |
| Multiplan | $85 | 986% |
| Phcs | $85 | 986% |
| Philadelphia American Life Insurance | $85 | 986% |
| Ameriben | $86 | 998% |
| Luminare Health (Detroit) | $86 | 998% |
| Ohiohealthy | $86 | 998% |
| Osu Not Independent Choice | $86 | 998% |
| Twin Valley Psychiatric | $86 | 998% |
| Health Smart | $91 | 1056% |
| Bccp | $107 | 1241% |
| Medicaid / KanCare | $107 | 1241% |
| Optima Health | $107 | 1241% |
| Crime Victim Assistance | $632 | 7332% |
| Ohio Safe Program | $632 | 7332% |