CMS Price Transparency Data
Culture, bacterial
Facility: Watsonville Community Hospital
Billing Code: 87070 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87070
- Insurance Median: $607
- Cash Discount Price: $659
- vs. Medicare Baseline: 70.42x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Watsonville Community Hospital is $607. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $659. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 70.42x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$659
Average discount available for prompt cash payment at this facility.
Insurance Median
$607
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: $659 (7645%)
Insurance Median: $607 (7042%)
Cash: $659 (7645% of Medicare)
Ins. Median: $607 (7042% 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 7042% of the Medicare baseline (a markup of 6942%). 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.
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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 | $9 - $659 | 104% |
| U.S. Dept. of Labor | $9 | 104% |
| Tricare | $9 | 104% |
| Ace-Usa | $9 | 104% |
| Medicare (plans) | $9 | 104% |
| Nx Health Network | $9 | 104% |
| Travelers Insurance | $9 - $1,098 | 104% |
| Gallagher Bassett Svcs | $9 | 104% |
| Western Growers Work Comp | $9 | 104% |
| Crawford & Co | $9 | 104% |
| Fleming & Associates | $9 | 104% |
| Fireman's Fund Work Comp | $9 | 104% |
| Hartford Workers' Comp | $9 | 104% |
| Workers Comp | $9 | 104% |
| Republic Idemnity W/Comp | $9 | 104% |
| Health Net of California | $9 - $689 | 104% |
| Secure Horizons | $9 | 104% |
| Miscellaneous Work Comp | $9 | 104% |
| Pinnacle Healthcare Uc | $9 | 104% |
| Veterans Administration | $9 | 104% |
| Kemper Group Workers Comp | $9 | 104% |
| Blue Shield PPO | $9 - $27 | 104% |
| Alignment Health Plan | $9 | 104% |
| Liberty Mutual Work Comp | $9 | 104% |
| Secure Horizons Dign HMO | $9 - $220 | 104% |
| Keenan & Assoc Work Comp | $9 | 104% |
| Beta Healthcare Group | $9 | 104% |
| Ccs/Monterey County | $11 | 128% |
| Medicaid / KanCare | $11 | 128% |
| Medi-Cal E.R. | $11 | 128% |
| California Childrens Srvs | $11 | 128% |
| Healthy Families | $11 - $27 | 128% |
| Medi-Cal/Eds | $11 | 128% |
| Well Path | $11 - $1,098 | 128% |
| Alliance/Sccho | $12 | 139% |
| Ufcw/Valley Clerks | $27 | 313% |
| Bs Employee | $27 | 313% |
| United Agriculture | $27 | 313% |
| Operating Engineers | $57 - $979 | 661% |
| Carpenters H&W Trust | $57 - $979 | 661% |
| Robert Kennedy/Ccn | $57 - $979 | 661% |
| City of Wats/Pinnacle Clm | $57 - $979 | 661% |
| Delta Health Systems | $57 - $979 | 661% |
| Sheet Metal Workers | $57 - $979 | 661% |
| Monterey Bay Pub Emp Trst | $57 - $979 | 661% |
| Pinnacle Claims Tpa/Bc | $57 - $979 | 661% |
| Blue Cross Blue Shield | $57 - $979 | 661% |
| Western Growers Trust/Bc | $57 - $979 | 661% |
| Laborers Health & Welfare | $57 - $979 | 661% |
| State Compensation Fund | $57 - $979 | 661% |
| Calif Ironworkers Field | $57 - $979 | 661% |
| Teamsters Benefit Trust | $57 - $979 | 661% |
| Claims Management Wc | $57 - $979 | 661% |
| Blue Shield HMO | $111 - $220 | 1288% |
| Pacificare HMO | $111 - $659 | 1288% |
| Health Net Pmg HMO | $111 - $689 | 1288% |
| Aetna | $111 - $901 | 1288% |
| Cigna | $111 - $769 | 1288% |
| Great-West/Phcs | $111 - $769 | 1288% |
| Medicruz | $198 | 2297% |
| Victim Compensation Plan | $198 - $1,098 | 2297% |
| Western Health Advantage | $549 | 6369% |
| Self Pay | $659 | 7645% |
| Pacificare PPO | $659 | 7645% |
| Health Net Smartcare Netw | $659 | 7645% |
| Health Net Blue and Gold | $689 | 7993% |
| Health Net Canopycare HMO | $689 | 7993% |
| First Health | $769 - $879 | 8921% |
| Adventist Risk Management | $769 - $879 | 8921% |
| Transwestern | $769 - $879 | 8921% |
| Geha (Ccn) | $769 - $879 | 8921% |
| Private Healthcare System | $857 | 9942% |
| Multiplan Inc PPO | $857 | 9942% |
| Salinas Valley Mem Hops | $934 | 10835% |
| Coastal Healthcare Admin | $934 - $989 | 10835% |
| North Calif Bakery Driver | $1,098 | 12738% |
| Physicians Mutual | $1,098 | 12738% |
| Wholesale Beer Distributo | $1,098 | 12738% |
| Miscellaneous Insurance | $1,098 | 12738% |
| State Farm Ins | $1,098 | 12738% |
| Aarp | $1,098 | 12738% |
| Farmers Insurance | $1,098 | 12738% |
| Humana | $1,098 | 12738% |
| Bankers Life & Casualty | $1,098 | 12738% |
| Prucare Pmg POS | $1,098 | 12738% |
| Zenith National Ins | $1,098 | 12738% |
| Apwu Health Plan | $1,098 | 12738% |
| United Administrative | $1,098 | 12738% |
| Allstate | $1,098 | 12738% |
| Aaa | $1,098 | 12738% |
| Prucare Pmg HMO | $1,098 | 12738% |
| Miscellaneous Auto | $1,098 | 12738% |
| Sutter Health Plus | $1,098 | 12738% |