CMS Price Transparency Data

Culture, bacterial

Facility: Forks Community Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87070
Insurance Median: $95
Cash Discount Price: $156
vs. Medicare Baseline: 11.02x Medicare

The contracted insurance negotiated median rate for a Culture, bacterial at Forks Community Hospital is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 11.02x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$156

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $156 (1810%)

Insurance Median: $95 (1102%)

Cash: $156 (1810% of Medicare)

Ins. Median: $95 (1102% 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 1102% of the Medicare baseline (a markup of 1002%). 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
UnitedHealthcare	$10 - $184	116%
Medicaid / KanCare	$39 - $79	452%
Coordinated Care (Mco) Mcd-All Plans	$42 - $81	487%
Community Health Network Mcr-All Other Plans	$50 - $97	580%
Humana	$50 - $97	580%
Tricare	$50 - $97	580%
Triwest-All Plans	$50 - $97	580%
Ambetter / Centene	$58 - $113	673%
Wellcare Med Adv - All Plans	$58 - $113	673%
Regence-All Other Plans	$64 - $124	742%
Community Health Exchange	$73 - $140	847%
Molina Commercial-All Other Plans	$103 - $199	1195%
Aetna	$106 - $205	1230%
Blue Cross Blue Shield	$106 - $205	1230%
Cigna	$112 - $216	1299%
First Choice-All Plans	$112 - $216	1299%
Medicare (plans)	$318	3689%

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 $156.
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 Forks 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.