CMS Price Transparency Data

Culture, bacterial

Facility: UPMC Lititz

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $30
  • Cash Discount Price: $48
  • vs. Medicare Baseline: 3.48x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at UPMC Lititz is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 3.48x the Medicare baseline. Located in 1500 Highlands Drive, Lititz, PA.
Cash / Self-Pay
$48

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $48 (557%)
Insurance Median: $30 (348%)
Cash: $48 (557% of Medicare)
Ins. Median: $30 (348% 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 348% of the Medicare baseline (a markup of 248%). 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%
Aetna $9 - $37 104%
Blue Cross Blue Shield $9 - $38 104%
Cigna $9 - $22 104%
Geisinger $9 - $58 104%
Health Partners Plans (Jefferson Health Plan) $9 104%
Highmark Wholecare (Prev Gateway) $9 104%
UnitedHealthcare $9 - $14 104%
Upmc Health Plan $9 - $56 104%
Upmc Work Partners $9 104%
Prime Net $11 - $58 128%
Keystone Autism Services $14 162%
Keystone Health Plan $16 - $38 186%
Preferred Healthcare System $44 - $60 510%
Multiplan $68 789%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 Highlands Drive, Lititz, PA 17543
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals