CMS Price Transparency Data

Culture, bacterial

Facility: Medical Center Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $18
Cash Discount Price: $167
vs. Medicare Baseline: 2.09x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Medical Center Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 2.09x the Medicare baseline. Located in 500 W 4Th Street, Odessa, TX.

Cash / Self-Pay

$167

Average discount available for prompt cash payment at this facility.

Insurance Median

$18

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: $167 (1937%)

Insurance Median: $18 (209%)

Cash: $167 (1937% of Medicare)

Ins. Median: $18 (209% 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 209% of the Medicare baseline (a markup of 109%). 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
Geha	$4	46%
UnitedHealthcare	$4 - $12	46%
Ambetter / Centene	$7 - $9	81%
Amerigroup	$7	81%
Blue Cross Blue Shield	$7 - $112	81%
Community Health Choice	$7	81%
Corvel Wc	$7	81%
First Care Health Plan	$7	81%
Medicaid / KanCare	$7 - $8	81%
Superior Chips	$7	81%
Superior Health Plan	$7	81%
Aetna	$8 - $172	93%
Novitas Solutions	$8	93%
Triwest Va Ccn	$8	93%
Care Improvement Plus	$9	104%
Humana	$9	104%
Wellcare By Allwell	$9	104%
Group Resources	$10	116%
Workers Comp	$17	197%
Health Select	$24 - $112	278%
90 Degree Benefits	$28 - $125	325%
Caprock	$38 - $44	441%
Cigna	$40	464%
Healthsmart Preferred Care	$41 - $157	476%
State Comptroller	$130	1508%
Texas Mutual Wc	$172	1995%
Firstcare	$183	2123%

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 $167.
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 Medical Center 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.