CMS Price Transparency Data

Culture, bacterial

Facility: Tristar Summit Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $194
  • Cash Discount Price: $772
  • vs. Medicare Baseline: 22.51x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Tristar Summit Medical Center is $194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $772. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 22.51x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.
Cash / Self-Pay
$772

Average discount available for prompt cash payment at this facility.

Insurance Median
$194

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: $772 (8956%)
Insurance Median: $194 (2251%)
Cash: $772 (8956% of Medicare)
Ins. Median: $194 (2251% 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 2251% of the Medicare baseline (a markup of 2151%). 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%
Aetna $7 - $603 81%
Ambetter / Centene $9 104%
American Health Advantage $9 104%
Amerigroup $9 104%
Atrio Golden Times $9 104%
Blue Cross Blue Shield $9 - $49 104%
Bright Health $9 - $10 104%
Devoted Health Plan $9 104%
Evergreen Hmo $9 104%
Healthspring $9 104%
Humana $9 - $784 104%
Odyssey Healthcare $9 104%
Sarah Cannon Research $9 104%
Signature Advantage $9 104%
United $9 - $543 104%
Wellcare $9 104%
Zing $9 104%
Prime Health $12 - $1,061 139%
Apex Health $13 - $229 151%
Corvel Corporation $13 151%
Kentucky Labor Cabinet $13 - $222 151%
Nhc Advantage, Inc. $13 - $229 151%
Novanet $13 151%
Pruitt Health (Allyalign) $13 - $229 151%
Cigna $16 - $965 186%
Oscar $26 302%
Centurion $29 - $497 336%
Bgfh Singlesource $36 - $1,025 418%
Multiplan $46 - $784 534%
Employers Health Network $50 - $844 580%
Odom'S Tn Pride Sausage $53 - $904 615%
Compsych $57 - $965 661%
Beech Street $62 - $1,061 719%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5655 Frist Blvd, Hermitage, TN 37076
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals