CMS Price Transparency Data

Culture, bacterial

Facility: Graham Regional Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $29
  • Cash Discount Price: $43
  • vs. Medicare Baseline: 3.36x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Graham Regional Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 3.36x the Medicare baseline. Located in 1301 Montgomery Road, Graham, TX.
Cash / Self-Pay
$43

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $43 (499%)
Insurance Median: $29 (336%)
Cash: $43 (499% of Medicare)
Ins. Median: $29 (336% 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 336% of the Medicare baseline (a markup of 236%). 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
Amerigroup $11 - $18 128%
Choicecare Network $11 - $18 128%
Superior Healthplan $11 - $18 128%
Wellpoint $15 - $24 174%
Aetna $23 - $39 267%
Cigna $23 - $39 267%
Blue Cross Blue Shield $24 - $45 278%
Three Rivers Provider Network $31 - $51 360%
Health Advantage Network $32 - $54 371%
Healthsmart Preferred Care $32 - $54 371%
Curative $58 - $96 673%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 Montgomery Road, Graham, TX 76450
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals