CMS Price Transparency Data

Culture, bacterial

Facility: Baylor Scott & White Medical Center at Irving

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $39
Cash Discount Price: $45
vs. Medicare Baseline: 4.52x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Baylor Scott & White Medical Center at Irving is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 4.52x the Medicare baseline. Located in 1901 N Macarthur Blvd, Irving, TX.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $45 (522%)

Insurance Median: $39 (452%)

Cash: $45 (522% of Medicare)

Ins. Median: $39 (452% 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 452% of the Medicare baseline (a markup of 352%). 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
Superior Health Plan	$6 - $29	70%
Wellpoint (Fka Amerigroup)	$6 - $29	70%
Baylor Scott & White Health Plan	$8 - $153	93%
Aetna	$9 - $145	104%
American Health Plan	$9	104%
Blue Cross Blue Shield	$9 - $42	104%
Corvel	$9	104%
Healthspring	$9	104%
Humana	$9 - $185	104%
Prime Health Services	$9	104%
Procare Advantage	$9	104%
Triwest	$9	104%
UnitedHealthcare	$10 - $11	116%
Ambetter / Centene	$18	209%
Cigna	$29 - $153	336%
Employers Health Network	$32 - $145	371%
Quiktrip	$32 - $145	371%
University Of Mary Hardin-Baylor	$34 - $153	394%
Imagine Health	$37 - $166	429%
Curative	$38 - $172	441%
First Health	$41 - $185	476%
Healthsmart	$41 - $198	476%
Private Health Care System	$44 - $198	510%

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 $45.
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 Baylor Scott & White Medical Center at Irving 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.