CMS Price Transparency Data

Blood antibody screen

Facility: Spanish Peaks Regional Health Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $197
  • Cash Discount Price: $197
  • vs. Medicare Baseline: 3.70x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Spanish Peaks Regional Health Center is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 3.70x the Medicare baseline. Located in 23500 Us Highway 160, Walsenburg, CO.
Cash / Self-Pay
$197

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

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: $197 (370%)
Insurance Median: $197 (370%)
Cash: $197 (370% of Medicare)
Ins. Median: $197 (370% 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 370% of the Medicare baseline (a markup of 270%). 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
Beacon Health Op Only-All Plans $6 11%
Blue Cross Blue Shield $107 - $197 201%
Humana $107 201%
Medicare (plans) $107 201%
UnitedHealthcare $107 - $204 201%
Devoted Health Mcr - All Plans $113 212%
Apostrophe - All Plans $197 370%
Cigna $197 370%
Friday Hp Chp - All Plans $197 370%
Kaiser Ppo - All Other Plans $197 370%
Prov Ntwrk Of America - All Plans $197 370%
Cofinity - All Plans $201 378%
Connect For Health - All Plans $204 383%
Rmhp - All Plans $204 383%
Multiplan Phcs - All Plans $208 391%
Kaiser Ppo Mcr $219 411%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 23500 Us Highway 160, Walsenburg, CO 81089
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals