CMS Price Transparency Data

Blood antibody screen

Facility: St Luke's Nampa Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $49
Cash Discount Price: $72
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at St Luke's Nampa Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.92x the Medicare baseline. Located in 9850 West St Lukes Drive, Nampa, ID.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

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: $72 (135%)

Insurance Median: $49 (92%)

Cash: $72 (135% of Medicare)

Ins. Median: $49 (92% 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.

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
Blue Cross Blue Shield	$10 - $164	19%
Commercial [1028]	$10 - $164	19%
Mountain Health Co-Op [1067]	$10 - $49	19%
Pacificsource [1020]	$10 - $56	19%
Select Health [1063]	$10 - $49	19%
Slplan Tap Mc St Lukes Health Plan [1641000001]	$10 - $49	19%
St Lukes Health Plan [1046]	$10 - $49	19%
UnitedHealthcare	$22 - $62	41%
Aetna	$34 - $68	64%
Cigna	$34 - $60	64%
Providence [1022]	$34 - $60	64%
Webtpa [1071]	$34 - $64	64%
First Health [1064]	$35 - $64	66%
Geha [1065]	$35 - $62	66%
United Medical Resources [1051]	$35 - $62	66%
Moda [1055]	$38 - $66	71%
Regence [1005]	$156 - $164	293%
Blue Shield Alt [100401]	$164	308%
Regence Out Of State [1004]	$164	308%

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 $72.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86850.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Luke's Nampa Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86850.
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.