CMS Price Transparency Data

Culture, bacterial

Facility: St Jude Childrens Research Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $37
Cash Discount Price: Unavailable
vs. Medicare Baseline: 4.29x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at St Jude Childrens Research Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 4.29x the Medicare baseline. Located in 262 Danny Thomas Place, Memphis, TN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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%)

Insurance Median: $37 (429%)

Ins. Median: $37 (429% 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 429% of the Medicare baseline (a markup of 329%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$6 - $55	70%
Home State Health	$8	93%
Medicaid / KanCare	$8 - $9	93%
Healthcare Connections La	$9	104%
Healthy Blue	$9	104%
Molina Marketplace Of Ms	$11	128%
Empower	$12	139%
Blue Cross Blue Shield	$18 - $28	209%
Tenncare Select Hmo	$20	232%
Health Choice - Ok	$46	534%
Vantage	$46 - $52	534%
Humana	$50	580%
Aetna	$58	673%
Private Health Care Systems	$62	719%
Ms Physicians Care Network	$65	754%
Baptist Health	$69	800%
Cigna	$69	800%
First Health Ccn	$69	800%
Health Choice	$69	800%
Health Link Mississippi	$69	800%
Healthscope Benefits Inc	$69	800%
Tricare	$77	893%

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 $X.
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 St Jude Childrens Research Hospital 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.