CMS Price Transparency Data

Culture, bacterial

Facility: Medical City Plano

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $274
  • Cash Discount Price: $808
  • vs. Medicare Baseline: 31.79x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Medical City Plano is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $808. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 31.79x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
$808

Average discount available for prompt cash payment at this facility.

Insurance Median
$274

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: $808 (9374%)
Insurance Median: $274 (3179%)
Cash: $808 (9374% of Medicare)
Ins. Median: $274 (3179% 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 3179% of the Medicare baseline (a markup of 3079%). 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%
United $7 - $159 81%
Aetna $8 - $552 93%
Cigna $8 - $128 93%
Molina $8 - $9 93%
Parkland Community Health Plan $8 93%
American Health Plan Of Texas, Inc. $9 104%
Blue Cross Blue Shield $9 - $405 104%
Care N Care $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 - $64 104%
Texas Independent Health Plan $9 104%
Triwest Health Alliance $9 104%
Triwest Veterans $9 104%
Wellcare $9 104%
Wellmed $9 104%
Universal Healthcare Group $10 116%
Verda Health Plan $11 128%
Bravo Health $13 151%
Superior $15 - $19 174%
Usa Managed Care $16 - $730 186%
Corvel Corporation $17 197%
Oscar $22 255%
Molina Healthcare $23 267%
Healthcare Highways $87 - $308 1009%
Evry Health $92 - $235 1067%
Lifecare Hospitals $106 - $274 1230%
Prominence Health Plan $142 - $365 1647%
City Of Mckinney $160 - $411 1856%
Fidelis Securecare $160 - $411 1856%
National Choicecare $177 - $456 2053%
Pc Texas Partners $195 - $502 2262%
Physicians Coop Of Tx $195 - $502 2262%
Rockport Health Group $195 - $502 2262%
Averde Health, Inc $206 - $529 2390%
Texas Healthcare Foundation Wc $231 - $593 2680%
Coastal Comp Health Networks $248 - $639 2877%
Mega Life $248 - $639 2877%
Multiplan Phcs $248 - $639 2877%
Healthsmart Preferred Care $266 - $684 3086%
Lewisville Isd/Dls Consulting $266 - $684 3086%
Usc Health Services $284 - $730 3295%
Galaxy Health Network $302 - $775 3503%
Independent Medical Systems $355 - $912 4118%
National Healthcare Solutions $355 - $912 4118%
Unicare $355 - $912 4118%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals