CMS Price Transparency Data

Culture, bacterial

Facility: Heritage Valley Beaver

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $9
Cash Discount Price: $14
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Heritage Valley Beaver is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.04x the Medicare baseline. Located in 1000 Dutch Ridge Road, Beaver, PA.

Cash / Self-Pay

$14

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $14 (162%)

Insurance Median: $9 (104%)

Cash: $14 (162% of Medicare)

Ins. Median: $9 (104% 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.

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
Aetna	$7 - $13	81%
Blue Cross Blue Shield	$8 - $17	93%
Gateway Health Plan	$8 - $9	93%
Cigna	$9 - $11	104%
Community Care Behavioral Health	$9	104%
UnitedHealthcare	$9 - $13	104%
Upmc Health Plan	$9 - $31	104%

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 $14.
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 Heritage Valley Beaver 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.