CMS Price Transparency Data

Culture, bacterial

Facility: Shriners Hospitals for Children

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $11
Cash Discount Price: $71
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Shriners Hospitals for Children is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.28x the Medicare baseline. Located in 950 West Faris Road, Greenville, SC.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

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: $71 (824%)

Insurance Median: $11 (128%)

Cash: $71 (824% of Medicare)

Ins. Median: $11 (128% 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 Mercy Health Plans	$7	81%
Ambetter / Centene	$9 - $16	104%
Cigna	$9	104%
Amerihealth Caritas Nc	$10 - $16	116%
Amerihealth Caritas Sc	$10	116%
Providence Health Plan	$10	116%
Blue Cross Blue Shield	$11 - $54	128%
Caresource Of Ga	$11	128%
Humana	$11	128%
Molina Healthcare Of Sc	$11	128%
Select Health Of Sc	$11	128%
Wellcare Of Ga	$11	128%
Sana Benefits	$12	139%
Alliance Health Tailored Plan	$16	186%
UnitedHealthcare	$16	186%
Wellcare Of Nc	$16	186%

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 $71.
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 Shriners Hospitals for Children 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.