CMS Price Transparency Data

Culture, bacterial

Facility: Saint Thomas Highlands Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $9
  • Cash Discount Price: $67
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Saint Thomas Highlands Hospital is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.04x the Medicare baseline. Located in 401 Sewell Dr, Sparta, TN.
Cash / Self-Pay
$67

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $67 (777%)
Insurance Median: $9 (104%)
Cash: $67 (777% of Medicare)
Ins. Median: $9 (104% 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
Community Plan $6 - $8 70%
Point Comfort Underwriters $8 93%
UnitedHealthcare $8 - $9 93%
Aetna $9 - $138 104%
Amerigroup Mcr Replacement $9 104%
Ascension Complete $9 104%
Blue Cross Blue Shield $9 - $25 104%
Centurion Of Tn $9 104%
Covid Uninsured Test Fund $9 104%
Healthspring Mcr Replacement $9 104%
Humana $9 104%
Medicare (plans) $9 104%
Nhc Advantage $9 104%
Ambetter / Centene $11 128%
Cigna $12 - $34 139%
Oscar Health $12 139%
Smart Health $12 139%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 Sewell Dr, Sparta, TN 38583
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals