CMS Price Transparency Data

Culture, bacterial

Facility: Tristar Northcrest Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $20
  • Cash Discount Price: $492
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Tristar Northcrest Medical Center is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $492. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 2.32x the Medicare baseline. Located in 100 Northcrest Drive, Springfield, TN.
Cash / Self-Pay
$492

Average discount available for prompt cash payment at this facility.

Insurance Median
$20

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: $492 (5708%)
Insurance Median: $20 (232%)
Cash: $492 (5708% of Medicare)
Ins. Median: $20 (232% 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 232% of the Medicare baseline (a markup of 132%). 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
Wellpoint $4 46%
Nhc Advantage, Inc. $6 - $318 70%
Aetna $7 - $838 81%
United $7 - $754 81%
Alive Hospice $9 104%
Ambetter / Centene $9 104%
American Health Advantage $9 104%
Amerigroup $9 104%
Atrio Golden Times $9 104%
Blue Cross Blue Shield $9 - $12 104%
Bright Health $9 - $10 104%
Cigna $9 - $491 104%
Devoted Health Plan $9 104%
Evergreen Hmo $9 104%
Healthspring $9 104%
Humana $9 - $34 104%
Molina $9 104%
Wellcare $9 - $11 104%
Zing $9 104%
Prime Health $12 139%
Novanet $13 151%
City Of Springfield $20 - $1,089 232%
Multiplan $24 - $1,374 278%
Oscar $26 302%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Northcrest Drive, Springfield, TN 37172
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals