CMS Price Transparency Data

Culture, bacterial

Facility: Medical City North Hills

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $22
  • Cash Discount Price: $875
  • vs. Medicare Baseline: 2.55x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Medical City North Hills is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $875. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 2.55x the Medicare baseline. Located in 4401 Booth Calloway Road, North Richland Hills, TX.
Cash / Self-Pay
$875

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $875 (10151%)
Insurance Median: $22 (255%)
Cash: $875 (10151% of Medicare)
Ins. Median: $22 (255% 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 255% of the Medicare baseline (a markup of 155%). 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
Cook Childrens Health Plan $5 58%
Amerigroup $7 - $9 81%
Parkland Community Health Plan $7 81%
United $7 - $195 81%
Aetna $8 - $658 93%
Cigna $8 - $724 93%
Molina $8 - $9 93%
American Health Plan Of Texas, Inc. $9 104%
Blue Cross Blue Shield $9 - $402 104%
Care N Care $9 104%
Cenpatico $9 104%
Devoted Health $9 104%
Humana $9 - $96 104%
Imperial Insurance Company $9 104%
Integranet $9 104%
Mutual Of Omaha $9 104%
Procare Advantge $9 104%
Provider Partners Health Plan $9 104%
Superior Health Plan $9 - $63 104%
Texas Independent Health Plan $9 104%
Triwest Veterans $9 104%
Wellcare $9 104%
Wellmed $9 104%
Triwest Health Alliance $10 116%
Universal Healthcare Group $10 116%
Verda Health Plan $11 128%
Bravo Health $13 151%
Superior $15 - $19 174%
Usa Managed Care $16 - $724 186%
Corvel Corporation $17 197%
Oscar $22 255%
Molina Healthcare $23 267%
Unicare $177 - $905 2053%
Healthcare Highways $207 - $306 2401%
Evry Health $218 - $234 2529%
City Of Mckinney $380 - $407 4408%
Fidelis Securecare $380 - $407 4408%
National Choicecare $422 - $453 4896%
Pc Texas Partners $464 - $498 5383%
Physicians Coop Of Tx $464 - $498 5383%
Rockport Health Group $464 - $498 5383%
Averde Health, Inc $490 - $525 5684%
Magellan Behavior Health $506 - $543 5870%
Coastal Comp Health Networks $591 - $634 6856%
Mega Life $591 - $634 6856%
Multiplan Phcs $591 - $634 6856%
Healthsmart Preferred Care $633 - $679 7343%
Lewisville Isd/Dls Consulting $633 - $679 7343%
Usc Health Services $675 - $724 7831%
Galaxy Health Network $717 - $769 8318%
Independent Medical Systems $844 - $905 9791%
National Healthcare Solutions $844 - $905 9791%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4401 Booth Calloway Road, North Richland Hills, TX 76180
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals