CMS Price Transparency Data

Culture, bacterial

Facility: Children's Hospital of Philadelphia

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $78
Cash Discount Price: $220
vs. Medicare Baseline: 9.05x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Children's Hospital of Philadelphia is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $220. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 9.05x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$220

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $220 (2552%)

Insurance Median: $78 (905%)

Cash: $220 (2552% of Medicare)

Ins. Median: $78 (905% 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 905% of the Medicare baseline (a markup of 805%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Geisinger Medical Assistance	$9	104%
Highmark Wholecare	$10	116%
Medicaid / KanCare	$10 - $133	116%
UnitedHealthcare	$10 - $444	116%
Health Partners	$11 - $152	128%
Aetna	$14 - $404	162%
Upmc Medical Assistance	$16 - $221	186%
Keystone First Chip	$18 - $251	209%
Keystone Health Plan East	$19 - $256	220%
Blue Cross Blue Shield	$21 - $324	244%
Geisinger Health Plan Commercial	$26 - $356	302%
Jefferson Health Plans	$28 - $382	325%
Cigna	$29 - $404	336%
Highmark	$29 - $404	336%
Horizon Nj Health	$32	371%
Qualcare	$32 - $444	371%
First Health Network	$38 - $525	441%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$47 - $646	545%
Private Health Care Systems	$47 - $646	545%
Choice Care Network	$53 - $727	615%

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 $220.
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 Children's Hospital of Philadelphia 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.