CMS Price Transparency Data

Culture, bacterial

Facility: Hospital of Univ of Pennsylvania

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $104
  • Cash Discount Price: $471
  • vs. Medicare Baseline: 12.06x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Hospital of Univ of Pennsylvania is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $471. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 12.06x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$471

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

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: $471 (5464%)
Insurance Median: $104 (1206%)
Cash: $471 (5464% of Medicare)
Ins. Median: $104 (1206% 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 1206% of the Medicare baseline (a markup of 1106%). 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
Gspp And Wissahickon Hospice $4 46%
Cigna $5 - $212 58%
Kaiser Permanente $7 - $471 81%
Medicaid / KanCare $7 - $471 81%
Pa Medical Assistance $7 - $471 81%
UnitedHealthcare $8 - $471 93%
Aetna $9 - $471 104%
Blue Cross Blue Shield $9 - $230 104%
Clover Health Plan $9 104%
Devoted Health $9 104%
Geisinger Health Plan $9 - $27 104%
Health Partners $9 - $471 104%
Humana $9 - $377 104%
Ibc $9 104%
Keystone Mercy Health Plan $9 - $471 104%
Medicare (plans) $9 104%
Pa Health And Wellness $9 - $14 104%
Penn Life (Living Independently For Elders) $9 104%
Philadelphia Va Medical Center $9 104%
Tricare $9 104%
Upmc $9 - $471 104%
Us Family Health Plan $9 104%
Keystone First $10 116%
Gateway Health Plan $11 128%
Elap $12 139%
Claims Watcher $14 - $16 162%
Ibc Commercial Hpn $15 174%
Oscar Health Plan $15 174%
Centivo $16 186%
Elap Services $16 186%
Keystone Hmo Proactive $16 186%
Highmark $18 209%
Penn Global Medicine $23 267%
Paired Kidney Exchange $38 441%
Horizon Nj Health $80 - $83 928%
Preferred Health Care Eliance $104 1206%
Pgm - Regie De L'Assurance Maladie Quebec $108 1253%
Pgm - Kuwait Defense $165 - $212 1914%
Qualcare $179 2077%
Olympus $185 2146%
Coventry $188 - $240 2181%
Pgm - Chop $188 2181%
Wissahickon Hospice $188 2181%
Healthamerica/Coventry $212 - $231 2459%
First Health Global $236 2738%
Health Net $283 3283%
Pgm - Royal Embassy Of Saudi Arabia $283 3283%
Pgm - Embassy Of Qatar $306 3550%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $306 3550%
Interlink $316 3666%
Pgm - Embassy Of The United Emirates/Ipc $330 3828%
Health America/Ccn $377 4374%
Intergroup $377 4374%
Pgm - Kuwait Health Division $377 4374%
Pgm - Kuwait Oil $377 4374%
Preferred Care $377 4374%
Blue Quality Centers For Transplant (Bqct) $471 5464%
City Of Philadelphia Behavioral Health $471 5464%
Commercial Other $471 5464%
International Pfs $471 5464%
United Behavioral Health $471 5464%
Workers Compensation $471 5464%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals