CMS Price Transparency Data

Culture, bacterial

Facility: Texas Health Hospital Frisco

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $221
Cash Discount Price: $196
vs. Medicare Baseline: 25.64x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Texas Health Hospital Frisco is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $196. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 25.64x the Medicare baseline. Located in 12400 N Dallas Parkway, Frisco, TX.

Cash / Self-Pay

$196

Average discount available for prompt cash payment at this facility.

Insurance Median

$221

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: $196 (2274%)

Insurance Median: $221 (2564%)

Cash: $196 (2274% of Medicare)

Ins. Median: $221 (2564% 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 2564% of the Medicare baseline (a markup of 2464%). 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
Amerigroup	$7 - $9	81%
Blue Cross Blue Shield	$7 - $51	81%
Parkland	$7	81%
UnitedHealthcare	$7 - $10	81%
Molina	$8 - $9	93%
Superior Wellcare	$8 - $9	93%
American Health	$9	104%
Healthspring	$9	104%
Humana	$9	104%
Fort Worth Firefighters	$17 - $243	197%
Aetna	$29 - $279	336%
Cigna	$35 - $375	406%
City Of Fort Worth	$85 - $187	986%
Quick Trip	$109 - $251	1265%
Phcs	$126 - $297	1462%
Healthsmart	$136 - $335	1578%
Multiplan	$158 - $347	1833%
Galaxy	$160 - $351	1856%
Usa	$160 - $351	1856%

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 $196.
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 Health Hospital Frisco 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.