CMS Price Transparency Data

Blood antibody screen

Facility: Clearwater Valley Hospital & Clinics

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $92
Cash Discount Price: $107
vs. Medicare Baseline: 1.73x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Clearwater Valley Hospital & Clinics is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.73x the Medicare baseline. Located in 301 Cedar Street, Orofino, ID.

Cash / Self-Pay

$107

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $107 (201%)

Insurance Median: $92 (173%)

Cash: $107 (201% of Medicare)

Ins. Median: $92 (173% 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	$59 - $104	111%
Aetna	$77 - $132	145%
Humana	$77 - $138	145%
Nimiipuu Mcr Adv-All Plans	$77	145%
Pacific Source - All Plans	$77	145%
Regence Blue Shield Mcr	$77	145%
Veterans Amin-All Plans	$77	145%
Corizon Correctnal Med-All Plans	$104	195%
Cigna	$128	240%
Idaho Phys Network-All Plans	$135	254%
Multiplan / Phcs-All Plans	$138	259%
First Choice-All Plans	$139	261%
Geha-All Plans	$139	261%
Regence Blue Shield-All Other Plans	$142	267%

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 $107.
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 Clearwater Valley Hospital & Clinics 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.