CMS Price Transparency Data

Blood antibody screen

Facility: St Mary's Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $118
  • Cash Discount Price: $107
  • vs. Medicare Baseline: 2.22x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at St Mary's Hospital is $118. 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 2.22x the Medicare baseline. Located in 701 Lewiston St, Cottonwood, ID.
Cash / Self-Pay
$107

Average discount available for prompt cash payment at this facility.

Insurance Median
$118

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: $118 (222%)
Cash: $107 (201% of Medicare)
Ins. Median: $118 (222% 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 222% of the Medicare baseline (a markup of 122%). 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
Blue Cross Blue Shield $59 - $136 111%
Aetna $116 - $132 218%
Medicare (plans) $116 218%
Regence Blue Shield Mcr $116 218%
Tricare $116 218%
UnitedHealthcare $116 218%
Veterans Admin - All Plans $116 218%
Nimiipuu Mcr Adv - Allplans $118 222%
Idaho Phys Network - All Plans $135 254%
Corizon Correctional - All Plans $136 255%
Geha - All Plans $138 259%
Multiplan - All Plans $138 259%
First Choice- All Plans $139 261%
Regence Blue Shield - All Other Plans $142 267%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Lewiston St, Cottonwood, ID 83522
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals