CMS Price Transparency Data

Culture, bacterial

Facility: Penn State Health St. Joseph

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $10
Cash Discount Price: $15
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Penn State Health St. Joseph is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.16x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$15

Average discount available for prompt cash payment at this facility.

Insurance Median

$10

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: $15 (174%)

Insurance Median: $10 (116%)

Cash: $15 (174% of Medicare)

Ins. Median: $10 (116% 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
[Amerihealth Caritas]	$7 - $9	81%
[Highmark Wholecare]	$7 - $9	81%
[Geisinger]	$8 - $40	93%
[Health Partners Plans]	$8 - $9	93%
[Pa Health & Wellness]	$8 - $9	93%
Aetna	$9 - $24	104%
Humana	$9	104%
UnitedHealthcare	$9 - $38	104%
[Cbc]	$9 - $30	104%
[Healthspring]	$9	104%
[Highmark]	$9 - $33	104%
[Ibc]	$9 - $28	104%
[Upmc]	$9 - $41	104%
[Point Comfort Underwriters]	$11	128%
Cigna	$25	290%
[Highmark Choice Blue]	$26	302%
[Highmark Aca]	$27	313%
[Preferred Healthcare Systems]	$42	487%
[First Health]	$45	522%
[Multiplan]	$45	522%

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 $15.
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 Penn State Health St. Joseph 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.