CMS Price Transparency Data

Drug screening test

Facility: Kootenai Health

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $105
Cash Discount Price: $85
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Kootenai Health is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 0.92x the Medicare baseline. Located in 2003 Kootenai Health Way, Coeur D'Alene, ID.

Cash / Self-Pay

$85

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$114.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $114.43 (100%)

Cash / Self-Pay: $85 (74%)

Insurance Median: $105 (92%)

Cash: $85 (74% of Medicare)

Ins. Median: $105 (92% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $114.43 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Molina Healthcare of Idaho	$20 - $118	17%
UnitedHealthcare	$34 - $137	30%
Premera	$46 - $114	40%
Mountain Health Co-Op	$58 - $118	51%
Cigna	$61 - $126	53%
Aetna	$62 - $223	54%
First Choice Health (Ameriben)	$64 - $132	56%
Interwest Health	$64 - $129	56%
Blue Cross Blue Shield	$68 - $249	59%
Wellpoint	$99 - $103	87%
Magellan	$99 - $103	87%
Coordinated Care of Washington	$105	92%
Molina Healthcare of Washington	$105	92%
Humana	$114	100%
Regence Blue Shield of Idaho	$114	100%
Pacificsource	$116 - $252	101%
Group Health/Kaiser	$412	360%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $85.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0480.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Kootenai Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0480.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.