CMS Price Transparency Data

Blood antibody screen

Facility: Boulder Community Health

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $157
  • Cash Discount Price: $116
  • vs. Medicare Baseline: 2.95x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Boulder Community Health is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.95x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$116

Average discount available for prompt cash payment at this facility.

Insurance Median
$157

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: $116 (218%)
Insurance Median: $157 (295%)
Cash: $116 (218% of Medicare)
Ins. Median: $157 (295% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 295% of the Medicare baseline (a markup of 195%). 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
Blue Cross Blue Shield $4 - $238 8%
UnitedHealthcare $4 - $55 8%
Aetna $7 - $348 13%
Humana $7 - $54 13%
Health Spring $8 - $43 15%
Medicare (plans) $8 - $152 15%
Select Health Colorado Public Option $8 - $152 15%
Select Health Value Network $8 - $152 15%
Cigna $11 - $320 21%
Multiplan $15 - $280 28%
Phcs $15 - $280 28%
Devoted Health $54 - $160 101%
Clear Spring $55 103%
Rocky Mountain Health Maintenance Organization $55 103%
Kaiser Public Option $103 193%
Rocky Mountain Health Maintenance Organization Private Plan $122 - $280 229%
Kaiser $126 237%
Kaiser Ppo $126 237%
Integrated Health Plans Bch $130 - $300 244%
Casualty Management Network, Prime Health Services Behavioral Health $148 - $340 278%
Mines And Associates $148 - $340 278%
Three Rivers Provider Network $148 - $340 278%
Zelis (Profee) $148 - $340 278%
Casualty Management Network, Prime Health Services Community Medical Associates $157 - $360 295%
National Preferred Provider Network $157 - $360 295%
Rockport Healthcare Group Community Medical Associates $157 - $360 295%
Usa $157 - $360 295%
Rockport Healthcare Group Bch $162 - $372 304%
Health Payors Organization $165 - $380 310%
Health Management Network Bch Community Medical Associates $167 - $384 314%
Health Management Network Community Medical Associates $167 - $384 314%
National Provider Network $169 - $388 317%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals