CMS Price Transparency Data

Blood antibody screen

Facility: Valor Health

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $33
Cash Discount Price: $67
vs. Medicare Baseline: 0.62x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Valor Health is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.62x the Medicare baseline. Located in 1202 East Locust Street, Emmett, ID.

Cash / Self-Pay

$67

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $67 (126%)

Insurance Median: $33 (62%)

Cash: $67 (126% of Medicare)

Ins. Median: $33 (62% 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 Shield Comm - All Other Plans	$7	13%
Pacificsource Comm - All Other Plans	$7	13%
Select Health Comm - All Other Plans	$7	13%
UnitedHealthcare	$7 - $66	13%
Tricare	$32	60%
Aetna	$33 - $59	62%
Blue Cross Blue Shield	$33 - $70	62%
Blue Shield Mcr Adv	$33	62%
Humana	$33 - $70	62%
Molina Mcr Adv - All Plans	$33	62%
Regence Bs Triwest - All Plans	$33	62%
Pacificsource Mcr Adv	$35	66%
Cigna	$64 - $66	120%
Moda Health - All Plans	$67	126%

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 $67.
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 Valor Health 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.