CMS Price Transparency Data

Culture, bacterial

Facility: Carilion Tazewell Community Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $124
Cash Discount Price: $69
vs. Medicare Baseline: 14.39x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Carilion Tazewell Community Hospital is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 14.39x the Medicare baseline. Located in 388 Ben Bolt Avenue, Tazewell, VA.

Cash / Self-Pay

$69

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

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: $69 (800%)

Insurance Median: $124 (1439%)

Cash: $69 (800% of Medicare)

Ins. Median: $124 (1439% 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 1439% of the Medicare baseline (a markup of 1339%). 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
Corvel	$8	93%
Abh Of Va (Formerly Coventry)	$9	104%
Abh Of Wva (Formerly Coventry)	$9	104%
Blue Cross Blue Shield	$9	104%
Humana	$9	104%
Sentara Health Plan	$9 - $122	104%
UnitedHealthcare	$9 - $161	104%
Aetna	$100 - $131	1160%
Gateway - Tier 3	$108	1253%
Vhn - Ultra	$122	1415%
Cigna	$125 - $133	1450%
Connecticare	$138	1601%
Vhn - Plus	$152	1763%
Gateway - Tier 2	$158	1833%
Vhn	$158	1833%
Integrated Health Plan	$167	1937%
Vhn - Link	$177	2053%
Gateway - Tier 1	$187	2169%
Vhn - Secondary Payors	$187	2169%
National Provider Network	$189	2193%

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 $69.
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 Carilion Tazewell Community Hospital 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.