CMS Price Transparency Data

Culture, bacterial

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $149
Cash Discount Price: $165
vs. Medicare Baseline: 17.29x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Texas Childrens Hospital North Austin Campus is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $165. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 17.29x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$165

Average discount available for prompt cash payment at this facility.

Insurance Median

$149

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: $165 (1914%)

Insurance Median: $149 (1729%)

Cash: $165 (1914% of Medicare)

Ins. Median: $149 (1729% 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 1729% of the Medicare baseline (a markup of 1629%). 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
Driscoll Children'S Health Plan Mcd	$9	104%
Superior Chip	$9	104%
Community Health Choice	$15 - $167	174%
First Care Health Plan	$24 - $167	278%
UnitedHealthcare	$24 - $167	278%
Molina Mcd	$27 - $78	313%
Blue Cross Blue Shield	$32 - $164	371%
Community First Health Plan Mcd	$36 - $104	418%
Cook Children'S Health Plan	$36 - $104	418%
Cigna	$51 - $167	592%
Aetna	$58 - $167	673%
Kelseycare	$58 - $170	673%
Healthsmart	$63 - $183	731%
Evolutions Healthcare	$68 - $196	789%
First Health	$79 - $248	916%
Multiplan	$81 - $235	940%
Galaxy Health Network	$86 - $248	998%

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 $165.
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 Texas Childrens Hospital North Austin Campus 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.