CMS Price Transparency Data

Blood antibody screen

Facility: Sonoma Valley Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $92
  • Cash Discount Price: $216
  • vs. Medicare Baseline: 1.73x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Sonoma Valley Hospital is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.73x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$216

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)
Cash / Self-Pay: $216 (406%)
Insurance Median: $92 (173%)
Cash: $216 (406% of Medicare)
Ins. Median: $92 (173% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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.

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
Medi-Cal $4 8%
Partnership Healthplan-All Plans $4 8%
Mcal Mgd Care (Php)-All Plans $6 11%
Blue Cross Blue Shield $10 - $308 19%
Bright Hlth/Brand New Day Mcr Adv $10 19%
Hospice Of Marin-All Plans $10 19%
St Joseph Heritage Hltcare Comm-All Other Plans $10 19%
Tricare $10 19%
Veterans Admin-All Plans $10 19%
Cdcr Prison-All Plans $12 23%
Three Rivers (Trpn)-All Plans $12 23%
Bright Hlth/Brand New Day - All Other Plands $13 24%
Chp - Correctional Health Partners - All Plans $13 24%
Wellpath - All Plans $14 26%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $18 34%
Canopy Health Solutions-All Other Plans $18 34%
UnitedHealthcare $19 36%
Aetna $21 39%
First Health(Coventry)-All Plans $21 39%
Meritage Medical Network Op Only Mcare $30 56%
Meritage Medical Network Op Only-All Other Plans $30 56%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $75 141%
Healthnet Hmo/Ppo-All Other Plans $108 203%
Blue Shield Ppo-All Plans $175 329%
Kaiser-All Plans $200 376%
Integrated Health Plan-All Plans $228 428%
Champus-All Plans $246 462%
Cigna $246 462%
Networks By Design - All Plans $246 462%
Comm Care Network(Ccn)-All Plans $262 492%
Great West-One Health Plan Ppo/Pos-All Plans $262 492%
Phcs/Multiplan/Beech St-All Plans $262 492%
Interplan-All Plans $271 509%
Bps-All Plans $277 520%
Ppo Alliance-All Plans $277 520%
Pref Health Networl(Phn)-All Plans $277 520%
Scan Mcare-All Plans $308 579%
St Joseph Heritage Hltcare Mcr Adv $308 579%
Correct Care Integ Health-All Plans $370 695%
Employer Direct Healthcare-All Plans $370 695%
Creative Legal Services-All Plans $400 751%
Canopy Op Only $554 1041%
Vnpn - All Plans $554 1041%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals