CMS Price Transparency Data

Culture, bacterial

Facility: Lancaster General Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $38
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 4.41x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Lancaster General Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 4.41x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $62 (719%)
Insurance Median: $38 (441%)
Cash: $62 (719% of Medicare)
Ins. Median: $38 (441% 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 441% of the Medicare baseline (a markup of 341%). 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 - $9 81%
Lancaster County Mh $7 81%
Medicaid / KanCare $7 - $17 81%
Tricare $7 81%
Gateway $8 93%
UnitedHealthcare $8 - $54 93%
Aetna $9 - $38 104%
Albright Life $9 104%
Blue Cross Blue Shield $9 - $54 104%
Cigna $9 - $53 104%
Coatesville Va $9 104%
Devoted Health $9 104%
Health Partners Mcr Advantage $9 104%
Highmark $9 - $63 104%
Hospice Generic $9 104%
Lebanon Veterans Hospital $9 104%
Medicare (plans) $9 104%
Pa Health And Wellness Mcr $9 104%
Elap Employees $12 139%
Hospice And Community Care $12 139%
Upmc For You $12 139%
Old Order Group $16 - $20 186%
Lg Coresource/Lg Eliance $17 - $18 197%
Oscar Health Plan $17 197%
Lancashire Hall $18 - $63 209%
Nursing Home Op Services $18 - $19 209%
Highmark Commercial Preferred $19 - $63 220%
Affilia Home Health $24 - $63 278%
Claim Watcher Plus $26 302%
Masonic Homes $26 - $63 302%
Eliance Health Solutions $27 - $40 313%
Claim Watcher $28 325%
Highmark Commercial Non-Preferred $29 - $63 336%
Elap Other Groups $31 360%
Preferred Healthcare $37 - $54 429%
Ehp $50 - $52 580%
Upmc Commercial $50 - $54 580%
Devon $52 - $54 603%
Geisinger Commercial $52 - $54 603%
Intergroup Services $52 - $54 603%
Medi-Share Christian Care $58 - $60 673%
Commercial Generic $61 - $63 708%
Magellan $61 - $63 708%
United Behavioral Health $61 - $63 708%
Value Options $61 - $63 708%
Workers Compensation $61 - $63 708%
Gift Of Life Donor Program $13,500 156613%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals