CMS Price Transparency Data

Culture, bacterial

Facility: North Austin Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $63
  • Cash Discount Price: $127
  • vs. Medicare Baseline: 7.31x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at North Austin Medical Center is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 7.31x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$127

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $127 (1473%)
Insurance Median: $63 (731%)
Cash: $127 (1473% of Medicare)
Ins. Median: $63 (731% 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 731% of the Medicare baseline (a markup of 631%). 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 - $251 58%
St David’S Hospice $7 - $9 81%
United $7 - $665 81%
Blue Cross Blue Shield $8 - $436 93%
Molina Healthcare $8 - $9 93%
Wellmed $8 93%
Aetna $9 - $74 104%
American Health Plan Of Texas $9 104%
Cigna $9 - $24 104%
Devoted Health $9 104%
Humana $9 104%
Imperial Insurance $9 104%
Odyssey Hospice $9 104%
Provider Partners Health Plan $9 104%
Pyramid Life $9 104%
Sendero $9 - $15 104%
Shared Health $9 104%
Texas Independent Health Plan $9 104%
Triwest Health Alliance $9 104%
Triwest Healthcare Alliance $9 104%
UnitedHealthcare $9 - $665 104%
Wellcare $9 104%
Universal Health $10 116%
Austin Fc $11 128%
Amerigroup $12 139%
Naphcare $13 151%
Seven Corners $13 151%
Corvel Corporation $17 197%
Moda $24 - $347 278%
Oscar $24 - $26 278%
Covenant Management Systems $30 - $425 348%
Healthcare Highways $30 - $443 348%
Imo Med - Select Network $31 - $443 360%
Nomi Health $33 - $546 383%
Moda Health $37 - $546 429%
Evry Health $38 - $544 441%
Texas Healthcare Foundation Heb $38 - $546 441%
Texas Workforce Commission $41 - $576 476%
Harbor Health Team $42 - $591 487%
Averde Health $47 - $665 545%
Comanche County $52 - $738 603%
National Choicecare $52 - $738 603%
Healthsmart Preferred Care $57 - $1,182 661%
Independent Medical Systems $57 - $812 661%
Physicians Cooperative Of Texas $57 - $812 661%
Prime Health $62 - $886 719%
First Health $65 - $1,049 754%
Coastal Comp Health Networks $68 - $960 789%
National Health Care $68 - $960 789%
Texas Municipal League $73 - $1,034 847%
Medcorp Southwest $78 - $1,108 905%
Rockport Healthcare Group $83 - $1,329 963%
Bce Emergis Corporation $94 - $1,329 1090%
Beech Street $94 - $1,329 1090%
Medical Control Network Solutions $94 - $1,329 1090%
Multiplan $94 - $1,329 1090%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals