CMS Price Transparency Data

Culture, bacterial

Facility: UPMC Mercy

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $69
  • Cash Discount Price: $121
  • vs. Medicare Baseline: 8.00x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at UPMC Mercy is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 8.00x the Medicare baseline. Located in 1400 Locust Street, Pittsburgh, PA.
Cash / Self-Pay
$121

Average discount available for prompt cash payment at this facility.

Insurance Median
$69

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: $121 (1404%)
Insurance Median: $69 (800%)
Cash: $121 (1404% of Medicare)
Ins. Median: $69 (800% 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 800% of the Medicare baseline (a markup of 700%). 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
Upmc Health Plan $7 - $39 81%
UnitedHealthcare $8 93%
Aetna $9 - $81 104%
Amerihealth Caritas $9 - $11 104%
Geisinger $9 104%
Highmark Wholecare (Prev Gateway) $9 - $10 104%
Pa Health & Wellness $9 - $12 104%
Upmc Work Partners $9 104%
Blue Cross Blue Shield $17 - $53 197%
Cigna $69 - $121 800%
Bravo $71 824%
Coventry/First Health $89 1032%
Intergroup $101 - $162 1172%
Private Health Care Systems $152 1763%
American Healthcare Group $162 1879%
National Provider Network $166 1926%
Health Payors Organization $182 2111%
Multiplan $182 2111%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 Locust Street, Pittsburgh, PA 15219
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals