CMS Price Transparency Data

Blood antibody screen

Facility: Saint Alphonsus Regional Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $129
  • Cash Discount Price: $109
  • vs. Medicare Baseline: 2.42x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Saint Alphonsus Regional Medical Center is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.42x the Medicare baseline. Located in 1055 North Curtis Road, Boise, ID.
Cash / Self-Pay
$109

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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: $109 (205%)
Insurance Median: $129 (242%)
Cash: $109 (205% of Medicare)
Ins. Median: $129 (242% 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 242% of the Medicare baseline (a markup of 142%). 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
Ada County Jail Inmate Ins $8 15%
Centurion Of Idaho $8 15%
Id County Ada $8 15%
Id County Canyon $8 15%
Id County Cat Fund $8 15%
Id County Payette $8 15%
Idaho Dept Health And Wellfare $8 15%
Medicaid / KanCare $8 - $72 15%
Selecthealth $14 - $150 26%
Blue Cross Blue Shield $37 - $55 69%
Cigna $38 71%
Priority Health $38 71%
Providence $38 - $142 71%
Bcn Domestic $41 77%
Blue Benefit Administrators Of Massachusetts $41 77%
Blue Care Network $41 77%
Blue Distinction Transplant $41 77%
Blue Shield - Ca $41 77%
Blue Shield - Ny Highmark Northeastern $41 77%
Blue Shield - Ny Highmark Western $41 77%
Blue Shield - Pa (Highmark) $41 77%
Blue Shield - Wa (Regence) $41 - $171 77%
Health Choices $41 77%
Kaiser Domestic $41 77%
Pre-Employment $41 77%
Wc Domestic $41 77%
Blue Shield - Id (Regence) $51 - $171 96%
Medicare (plans) $55 - $58 103%
UnitedHealthcare $55 - $167 103%
Moda Health $56 - $150 105%
Aetna $57 - $153 107%
American Health Advantage Of Idaho $57 107%
Trillium Community Ohp $72 135%
Mountain Health Co-Op $100 188%
Pacificsource Health Plans $100 - $122 188%
Columbia Health Network $122 229%
Allegiance $124 233%
Molina Marketplace $133 250%
Employee Benefit Management $142 267%
First Choice Health $142 267%
Webtpa $142 - $149 267%
Humana $147 - $167 276%
Allied National Global Care $150 282%
Asrm - Reliance Standard Life Insurance $150 282%
Christian Care Ministry $150 282%
Dean Health $150 282%
Fallon Health $150 282%
Family Life Insurance Company $150 282%
First Health $150 282%
Geha $150 - $153 282%
Ghc Scw $150 282%
Healthnet $150 282%
International Benefit Administrators $150 282%
Lifetime Benefit Solutions $150 282%
Manhattan Life $150 282%
Medi Share $150 282%
Pai $150 282%
Pan-American Life $150 282%
Paramount Hmo $150 282%
Phcs $150 282%
Trinity Health Share $150 282%
Allied Benefit Systems $153 287%
Ameriben $153 287%
Asr Health Benefits $153 287%
Boon Chapman $153 287%
Christian Brother Services $153 287%
Healthez $153 287%
Luminare Health (Detroit) $153 287%
Meritain $153 287%
Rural Carrier Health Benefit Plan $153 287%
Asuris Northwest Health $171 321%
Healthcare Management Admin $171 321%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1055 North Curtis Road, Boise, ID 83706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals