CMS Price Transparency Data

Culture, bacterial

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $173
  • Cash Discount Price: $98
  • vs. Medicare Baseline: 20.07x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Cincinnati Children's Hospital Medical Center is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 20.07x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$98

Average discount available for prompt cash payment at this facility.

Insurance Median
$173

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: $98 (1137%)
Insurance Median: $173 (2007%)
Cash: $98 (1137% of Medicare)
Ins. Median: $173 (2007% 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 2007% of the Medicare baseline (a markup of 1907%). 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 - $183 104%
Humana $9 - $48 104%
Passport_Ky $9 - $50 104%
United_Health_Care_Ky $9 - $51 104%
Wellcare_Ky $9 - $51 104%
Blue Cross Blue Shield $11 - $190 128%
Mhs_In $11 128%
Caresource_In $12 139%
Caresource_Oh $25 290%
United_Health_Care_Oh $26 302%
Amerihealth_Caritas_Oh $27 313%
Molina_Oh $27 313%
Buckeye_Oh $29 336%
Caresource_Oh_Insurance $93 1079%
Cigna $93 - $183 1079%
Medical_Mutual_Of_Ohio_Insurance $120 - $183 1392%
Point_Comfort_Insurance $125 1450%
Margaret_Mary_Health_Insurance $151 1752%
Parkview_Signature_Care_Insurance $151 1752%
United_Health_Care_Insurance $173 2007%
Health_Ohio_Network_Insurance $176 - $183 2042%
Custom_Design_Benefits_Insurance $183 2123%
Health_Smart_Preferred_Insurance $183 2123%
Medical_Benefit_Administrators_Insurance $183 2123%
Ohio_Health_Choice_Insurance $183 2123%
Private_Health_Care_Systems_Insurance $185 2146%
Beechstreet_Insurance $189 2193%
First_Health_Group_Insurance $189 2193%
Health_Link_Insurance $189 2193%
Evolutions_Health_Care_Systems $193 2239%
Galaxy_Health_Insurance $193 2239%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens