Culture, bacterial
Facility: Charleston Area Medical Center
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $146
- Cash Discount Price: $180
- vs. Medicare Baseline: 16.94x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 1694% of the Medicare baseline (a markup of 1594%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| The Health Plan of West Virginia Inc. | $8 - $188 | 93% |
| Aetna | $8 - $190 | 93% |
| Triwest VA | $8 | 93% |
| Unicare Health Plan of West Virginia Inc. | $8 | 93% |
| UnitedHealthcare | $9 - $190 | 104% |
| West Virginia Senior Advantage Inc. | $9 | 104% |
| Choicecare Network | $9 - $190 | 104% |
| Optimum Choice Inc. | $9 | 104% |
| Blue Cross Blue Shield | $9 - $177 | 104% |
| Integrated Medical Solutions | $17 | 197% |
| Naphcare | $17 | 197% |
| Caresource | $22 | 255% |
| Tricare | $42 - $116 | 487% |
| City of Charleston | $52 - $146 | 603% |
| Cigna | $65 - $180 | 754% |
| Three Rivers Providers Network | $68 - $188 | 789% |
| Multiplan | $69 - $190 | 800% |
| Healthsmart | $69 - $190 | 800% |
Consumer Guidance & Cost Commentary
Charleston Area Medical Center, located at 501 Morris Street in Charleston, WV, reported a cash median price of $180 for CPT code 87070 (Culture, bacterial). This facility, a voluntary non-profit acute care hospital, has a facility rating of 2. While the cash rate is available for patients paying directly, commercial insurance plans negotiated significantly higher rates, with the median negotiated amount reaching $146 and individual plan rates ranging from a low of $8 to a high of $190 across various carriers. It is important to note that for patients with high-deductible plans, the cash price of $180 may be more affordable than the insurance negotiated rate if the patient's out-of-pocket costs exceed the facility's contracted fees.
The data indicates a stark contrast between commercial pricing and the Medicare benchmark, which stands at $8.62 for this procedure. The commercial negotiated rates are substantially higher than the Medicare amount, with the highest negotiated rates reaching $190. Patients should be aware that hospitals often issue summary bills that obscure individual charges; requesting an itemized billing audit is the most effective way to identify errors, unbundled codes, or services not rendered before finalizing payment. Additionally, consumers should proactively inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid upfront, and avoid automatic claims submission by signing a waiver of insurance submission if they intend to pay cash directly.