CMS Price Transparency Data

Culture, bacterial

Facility: Ascension Seton Hays

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $47
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 5.45x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Ascension Seton Hays is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 5.45x the Medicare baseline. Located in 6001 Kyle Pkwy, Kyle, TX.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $63 (731%)
Insurance Median: $47 (545%)
Cash: $63 (731% of Medicare)
Ins. Median: $47 (545% 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 545% of the Medicare baseline (a markup of 445%). 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
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 - $16 81%
Wellpoint Chip/Chip Perinate $7 - $9 81%
Wellpoint Star Kids $7 81%
Aarp Mc Wellmed $8 93%
Addr Cancer Together $9 104%
Aetna $9 - $64 104%
Connected Senior Care $9 104%
Covid Hrsa $9 104%
Cshcn Cidc $9 104%
Devoted Health Mcr Replacement $9 104%
Humana $9 - $14 104%
Medicare (plans) $9 104%
Pphp Mcr Advantage $9 104%
Research Study $9 104%
Sendero Chap $9 104%
Smarthealth $9 104%
Superior Allwell $9 104%
Tricare $9 104%
Tx Independence Hp $9 104%
Utmb $9 104%
Wellcare Med Advantage $9 104%
Champva $10 - $12 116%
Occunet $12 139%
Sendero Idealcare $15 174%
Cigna $20 232%
Seton Performance Plus $21 244%
Covenant Health $47 545%
Superior Star $57 - $147 661%
Superior Star Foster $57 - $147 661%
Superior Star Kids $57 - $147 661%
Superior Star Plus $57 - $147 661%
Superior Chip/Chip Perinate $64 - $165 742%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6001 Kyle Pkwy, Kyle, TX 78640
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals