CMS Price Transparency Data

Culture, bacterial

Facility: Texas Orthopedic Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $183
  • Cash Discount Price: $1,035
  • vs. Medicare Baseline: 21.23x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Texas Orthopedic Hospital is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,035. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 21.23x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$1,035

Average discount available for prompt cash payment at this facility.

Insurance Median
$183

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: $1,035 (12007%)
Insurance Median: $183 (2123%)
Cash: $1,035 (12007% of Medicare)
Ins. Median: $183 (2123% 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 2123% of the Medicare baseline (a markup of 2023%). 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
Superior Health Plan $5 - $109 58%
Amerigroup $7 - $9 81%
Community Health Choice Mcd $7 81%
Texas Childrens Health Plans $7 - $301 81%
Texas Health Network $7 81%
United $7 - $816 81%
Aetna $8 - $50 93%
Molina Healthcare $8 - $19 93%
Oscar $8 - $25 93%
American Health Plan $9 104%
Blue Cross Blue Shield $9 - $635 104%
Christus (Usfhp) $9 104%
Cigna $9 - $45 104%
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%
Shared Health $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%
Texas Workforce Commission $21 - $435 244%
Evry Health $24 - $495 278%
Healthcare Highways $26 302%
Imagine Health $30 - $635 348%
Healthsmart Preferred Care $37 - $1,542 429%
Averde Health $39 - $816 452%
Fidelis Securecare Of Tx $39 - $816 452%
Coventry National First Health $46 - $967 534%
Physicians Cooperative Of Texas $47 - $998 545%
Rockport Workers Comp $47 - $998 545%
Independent Medical System $52 - $1,088 603%
National Healthcare Solutions $52 - $1,088 603%
Southwest Medical $52 - $1,088 603%
Coastal Comp $56 - $1,179 650%
Multiplan $65 - $1,542 754%
International Health Insurance $69 - $1,451 800%
Physicians, Inc $73 - $1,542 847%
Affiliated Ppo $78 - $1,633 905%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals