CMS Price Transparency Data

Culture, bacterial

Facility: Physicians Regional Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $10
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Physicians Regional Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.16x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $70 (812%)
Insurance Median: $10 (116%)
Cash: $70 (812% of Medicare)
Ins. Median: $10 (116% 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.

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
Amerigroup $4 - $9 46%
Amerigroup Community Care $4 46%
Medicaid / KanCare $4 46%
UnitedHealthcare $4 - $316 46%
Department Of Veterans Affairs $8 93%
Humana $8 93%
Medicare (plans) $8 93%
Node Bluecare Plus Tn Mcr Adv $8 - $9 93%
Tricare $8 93%
Aetna $9 - $32 104%
Blue Cross Blue Shield $9 - $61 104%
Node Devoted Health Mcr Adv $9 104%
Node Farm Bureau Mcr Adv $9 104%
Node Healthspring Mcr Adv $9 104%
Node Hospice Non Par Agree $9 104%
Node Nhc Mcr Adv $9 104%
Node Va $9 104%
Veterans Eval Services $9 104%
Wellcare $9 104%
Node Us Dept Of Labor $11 128%
Us Department Of Labor $11 128%
Cigna $13 151%
Novanet Work Comp Tn $13 151%
Occunet Work Comp Tn $13 151%
Tn Work Comp $13 151%
Ambetter / Centene $16 186%
Node Point Comfort Underwriters $16 186%
Self Pay $69 - $72 800%
Multiplan $171 - $224 1984%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals