CMS Price Transparency Data

Culture, bacterial

Facility: Dominion Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $276
Cash Discount Price: $460
vs. Medicare Baseline: 32.02x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Dominion Hospital is $276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $460. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 32.02x the Medicare baseline. Located in 2960 Sleepy Hollow Road, Falls Church, VA.

Cash / Self-Pay

$460

Average discount available for prompt cash payment at this facility.

Insurance Median

$276

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: $460 (5336%)

Insurance Median: $276 (3202%)

Cash: $460 (5336% of Medicare)

Ins. Median: $276 (3202% 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 3202% of the Medicare baseline (a markup of 3102%). 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
Align Senior Care	$9	104%
Cigna	$9	104%
Clear Spring Health Plan	$9	104%
Davita Village Health	$9	104%
Devoted	$9	104%
Humana	$9	104%
Johns Hopkins	$9	104%
Pyramid Life	$9	104%
United Behavioral Health	$9	104%
Virginia Premier Health	$9	104%
Managed Health Network	$10	116%
Carefirst	$173 - $281	2007%
Aetna	$221 - $337	2564%
Greenvbrier Sporting Club	$221 - $337	2564%
Value Options	$221 - $337	2564%
Virginia Health Network	$261 - $398	3028%
Corvel	$265 - $404	3074%
Phcs	$276 - $421	3202%
4Most Health Network	$331 - $505	3840%
Multiplan	$331 - $505	3840%

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 $460.
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 Dominion 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.