CMS Price Transparency Data

Culture, bacterial

Facility: Ascension Seton Highland Lakes

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $21
Cash Discount Price: $60
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Ascension Seton Highland Lakes is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 2.44x the Medicare baseline. Located in Highway 281 South, Burnet, TX.

Cash / Self-Pay

$60

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

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: $60 (696%)

Insurance Median: $21 (244%)

Cash: $60 (696% of Medicare)

Ins. Median: $21 (244% 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 244% of the Medicare baseline (a markup of 144%). 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
Blue Cross Blue Shield	$6 - $41	70%
Dell Chip/Chip Perinate	$6 - $9	70%
Dell Star	$6 - $9	70%
UnitedHealthcare	$6 - $9	70%
Wellpoint Star	$6 - $9	70%
Wellpoint Star Plus	$6 - $9	70%
Ambetter / Centene	$7 - $10	81%
Superior Star	$7 - $217	81%
Superior Star Plus	$7 - $217	81%
Wellpoint Chip/Chip Perinate	$7 - $9	81%
Wellpoint Star Kids	$7	81%
Sendero Chap	$8 - $65	93%
Champva	$10 - $12	116%
Humana	$10 - $76	116%
Cigna	$20	232%
Seton Performance Plus	$21	244%
Aetna	$23 - $64	267%
Superior Star Foster	$28 - $217	325%
Superior Star Kids	$28 - $217	325%
Superior Chip/Chip Perinate	$32 - $244	371%
Covenant Health	$47	545%

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 $60.
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 Ascension Seton Highland Lakes 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.