CMS Price Transparency Data

Culture, bacterial

Facility: HCA Houston Healthcare West

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $255
  • Cash Discount Price: $926
  • vs. Medicare Baseline: 29.58x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at HCA Houston Healthcare West is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $926. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 29.58x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
$926

Average discount available for prompt cash payment at this facility.

Insurance Median
$255

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: $926 (10742%)
Insurance Median: $255 (2958%)
Cash: $926 (10742% of Medicare)
Ins. Median: $255 (2958% 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 2958% of the Medicare baseline (a markup of 2858%). 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
Amerigroup $7 - $9 81%
Community Health Choice Mcd $7 81%
Texas Childrens Health Plans $7 - $159 81%
Texas Health Network $7 81%
United $7 - $430 81%
Aetna $8 - $57 93%
Molina Healthcare $8 - $19 93%
Oscar $8 - $25 93%
American Health Plan $9 104%
Blue Cross Blue Shield $9 - $334 104%
Chc Harris Health $9 104%
Christus (Usfhp) $9 104%
Cigna $9 - $764 104%
Devoted Health $9 104%
Humana $9 - $115 104%
Integranet Amerigroup Ipa $9 104%
Kelsey Seybold $9 104%
Molina $9 104%
Procare Advantage $9 104%
Provider Partners Health Plan Of Texas $9 104%
Renaissance Ipa Radiology $9 104%
Shared Health $9 104%
Superior Health Plan $9 - $57 104%
Triwest Health Alliance $9 104%
Triwest Healthcare Alliance $9 104%
Van Lang Ipa $9 104%
Wellcare $9 104%
Wellmed $9 104%
Universal Healthcare Group $10 116%
Verda Health Plan $11 128%
Community Health Choice $12 139%
Superior $12 - $13 139%
Corvel Corporation $17 197%
Omni Healthcare $18 209%
Healthcare Highways $26 302%
Texas Workforce Commission $127 - $229 1473%
Evry Health $144 - $261 1671%
Imagine Health $185 - $334 2146%
Healthsmart Preferred Care $227 - $812 2633%
Averde Health $238 - $430 2761%
Fidelis Securecare Of Tx $238 - $430 2761%
Coventry National First Health $281 - $509 3260%
Physicians Cooperative Of Texas $290 - $525 3364%
Rockport Workers Comp $290 - $525 3364%
Independent Medical System $317 - $573 3677%
National Healthcare Solutions $317 - $573 3677%
Southwest Medical $317 - $573 3677%
Triumph $317 - $573 3677%
Coastal Comp $343 - $621 3979%
Multiplan $396 - $812 4594%
Physicians, Inc $449 - $812 5209%
Affiliated Ppo $475 - $860 5510%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals