CMS Price Transparency Data

Culture, bacterial

Facility: Prosser Memorial Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $135
  • Cash Discount Price: $93
  • vs. Medicare Baseline: 15.66x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Prosser Memorial Hospital is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 15.66x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.
Cash / Self-Pay
$93

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $93 (1079%)
Insurance Median: $135 (1566%)
Cash: $93 (1079% of Medicare)
Ins. Median: $135 (1566% 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 1566% of the Medicare baseline (a markup of 1466%). 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
UnitedHealthcare $15 - $68 174%
Kaiser Permanente $34 - $154 394%
Community Health Plan Of Washington $36 - $68 418%
Coordinated Care $36 - $68 418%
Amerigroup $38 - $73 441%
Molina $38 - $68 441%
Health Alliance Northwest $42 487%
Wellcare $42 487%
Humana $43 - $144 499%
Aetna $51 - $144 592%
Ambetter / Centene $118 - $130 1369%
Asuris $135 - $152 1566%
Health Management Adminstrators $135 - $152 1566%
Premera $135 1566%
Regence $135 - $152 1566%
Cigna $139 1613%
First Choice $144 1671%
Multiplan $144 - $152 1671%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 723 Memorial Street, Prosser, WA 99350
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals