CMS Price Transparency Data

Culture, bacterial

Facility: Reading Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $68
  • Cash Discount Price: $112
  • vs. Medicare Baseline: 7.89x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Reading Hospital is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 7.89x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$68

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: $112 (1299%)
Insurance Median: $68 (789%)
Cash: $112 (1299% of Medicare)
Ins. Median: $68 (789% 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 789% of the Medicare baseline (a markup of 689%). 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
Amerihealth Caritas $7 81%
Geisinger $8 - $108 93%
Keystone First $8 93%
Upmc $8 - $92 93%
Blue Cross Blue Shield $9 - $77 104%
Gateway $9 104%
Health Partners $9 104%
Pa Health & Wellness $9 104%
UnitedHealthcare $9 - $10 104%
Wernersville State Hospital $9 104%
Aetna $17 - $92 197%
Pma $60 - $68 696%
Lehigh Valley Health Network $67 - $76 777%
Cigna $85 - $97 986%
First Health $89 - $101 1032%
Berkshire $112 - $128 1299%
Blue Ridge $142 - $162 1647%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 420 S 5Th Avenue, West Reading, PA 19611
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals