CMS Price Transparency Data
Blood antibody screen
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 86850 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86850
- Insurance Median: $50
- Cash Discount Price: $109
- vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Saint Alphonsus Medical Center Ontario is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.94x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$109
Average discount available for prompt cash payment at this facility.
Insurance Median
$50
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: $109 (205%)
Insurance Median: $50 (94%)
Cash: $109 (205% of Medicare)
Ins. Median: $50 (94% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $7 - $50 | 13% |
| Healthnet | $10 | 19% |
| Selecthealth | $14 - $150 | 26% |
| Ada County Jail Inmate Ins | $50 | 94% |
| Aetna | $50 - $158 | 94% |
| Ambetter / Centene | $50 | 94% |
| Amish Mennonite | $50 | 94% |
| Bcccp-Michigan | $50 | 94% |
| Bccp | $50 | 94% |
| Blue Cross Blue Shield | $50 - $203 | 94% |
| Bmc Healthnet | $50 | 94% |
| Breast Grant-Connecticut | $50 | 94% |
| California Health And Wellness | $50 | 94% |
| Cardinal Innovations Lme | $50 | 94% |
| Care Oregon Ohp | $50 | 94% |
| Cencal Health Plan | $50 | 94% |
| Cenpatico | $50 | 94% |
| Centurion Of Idaho | $50 | 94% |
| Chhuny | $50 | 94% |
| Childrens Comm Health Plan | $50 | 94% |
| Childrens Medical Services Title 19 | $50 | 94% |
| Cigna | $50 - $157 | 94% |
| Community Benefit Health | $50 | 94% |
| Community Care Behavorial Health | $50 | 94% |
| Community Health Choice | $50 | 94% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $50 | 94% |
| Dean Wi Badgercare | $50 | 94% |
| Delaware First Health | $50 | 94% |
| Delta Dental Nj | $50 | 94% |
| Dph Tb Program | $50 | 94% |
| Dscc | $50 | 94% |
| Eastpointe Lme | $50 | 94% |
| Family Health Network | $50 | 94% |
| Freedom First Healthcare | $50 | 94% |
| Ghc Scw Wi Badgercare | $50 | 94% |
| Harbor Health | $50 | 94% |
| Health Safety Net | $50 | 94% |
| Healthy Blue Ne | $50 | 94% |
| Hennepin Health | $50 | 94% |
| Humana | $50 - $147 | 94% |
| Id County Ada | $50 | 94% |
| Id County Canyon | $50 | 94% |
| Id County Cat Fund | $50 | 94% |
| Id County Payette | $50 | 94% |
| Idaho Womens Health Check | $50 | 94% |
| Indiana Breast Cervical Cancer | $50 | 94% |
| Inland Empire Health Plan | $50 | 94% |
| Intercommunity Health Ohp | $50 | 94% |
| Iowa Total Care | $50 | 94% |
| Jai Medical System | $50 | 94% |
| Kern Family Health Plan | $50 | 94% |
| Keystone First | $50 | 94% |
| Keystone First Chip | $50 | 94% |
| La Care Health Plan | $50 | 94% |
| Lakeland Care Inc | $50 | 94% |
| Managed Health Services - Indiana | $50 | 94% |
| Maryland Breast & Cervical Program | $50 | 94% |
| Maryland Healthy Smiles - Scion Dental | $50 | 94% |
| Maryland Physicians Care | $50 | 94% |
| Massachusetts Behavioral Health Partnership | $50 | 94% |
| Mdwise | $50 | 94% |
| Medi-Cal | $50 | 94% |
| Medi-Cal Healthnet | $50 | 94% |
| Medstar Dc Healthy Family | $50 | 94% |
| Medstar Md Health Choice | $50 | 94% |
| Mo Home State Health Plan | $50 | 94% |
| Molina Centennial Care | $50 | 94% |
| Nascentia Health Options | $50 | 94% |
| Nebraska Total Care | $50 | 94% |
| New York Cancer Services Program | $50 | 94% |
| Nextlevel Health | $50 | 94% |
| Oregon Screenwise | $50 | 94% |
| Pace Of Southwest Michigan | $50 | 94% |
| Paramount Advantage | $50 | 94% |
| Parkland Community Health Plan | $50 | 94% |
| Partners Behavioral Lme | $50 | 94% |
| Peach State Healthplan | $50 | 94% |
| Presbyterian Centennial Care | $50 | 94% |
| Prestige Health Choice | $50 | 94% |
| Priority Partners | $50 | 94% |
| Rx 340B Pass Along | $50 | 94% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $50 | 94% |
| Rx Medi-Cal | $50 | 94% |
| Rx Meridian Rx | $50 | 94% |
| Sandhills Center Lme | $50 | 94% |
| Screening For Life | $50 | 94% |
| Sunshine State Health Plan | $50 | 94% |
| Superior Health | $50 | 94% |
| Tenncare | $50 | 94% |
| Texas Children'S Health Plan | $50 | 94% |
| Trillium Community Ohp | $50 | 94% |
| Tufts Health Public Plans | $50 | 94% |
| UnitedHealthcare | $50 - $160 | 94% |
| Vaya Health Lme | $50 | 94% |
| Wellsense Health Plan | $50 | 94% |
| Wi Womens Wellness | $50 | 94% |
| Medicare (plans) | $61 - $65 | 115% |
| American Health Advantage Of Idaho | $63 | 118% |
| Mountain Health Co-Op | $100 | 188% |
| Pacificsource Health Plans | $100 - $157 | 188% |
| Moda Health | $120 - $162 | 225% |
| Allegiance | $127 | 239% |
| Correctional Health Partners | $130 | 244% |
| Columbia Health Network | $134 | 252% |
| Allied National Global Care | $150 | 282% |
| Asrm - Reliance Standard Life Insurance | $150 | 282% |
| Christian Care Ministry | $150 | 282% |
| Dean Health | $150 | 282% |
| Fallon Health | $150 | 282% |
| Family Life Insurance Company | $150 | 282% |
| First Choice Health | $150 | 282% |
| Ghc Scw | $150 | 282% |
| International Benefit Administrators | $150 | 282% |
| Lifetime Benefit Solutions | $150 | 282% |
| Manhattan Life | $150 | 282% |
| Pai | $150 | 282% |
| Pan-American Life | $150 | 282% |
| Paramount Hmo | $150 | 282% |
| Phcs | $150 | 282% |
| Trinity Health Share | $150 | 282% |
| Webtpa | $150 - $164 | 282% |
| Lifewise | $155 | 291% |
| Priority Health | $157 | 295% |
| Allied Benefit Systems | $158 | 297% |
| Ameriben | $158 | 297% |
| Asr Health Benefits | $158 | 297% |
| Christian Brother Services | $158 | 297% |
| Geha | $158 - $160 | 297% |
| Healthez | $158 | 297% |
| Luminare Health (Detroit) | $158 | 297% |
| Rural Carrier Health Benefit Plan | $158 | 297% |
| First Health | $159 | 299% |
| Medi Share | $159 | 299% |
| Providence | $159 | 299% |
| Blue Benefit Administrators Of Massachusetts | $203 | 381% |
| Blue Care Network | $203 | 381% |
| Blue Distinction Transplant | $203 | 381% |
| Blue Shield - Ca | $203 | 381% |
| Blue Shield - Id (Regence) | $203 | 381% |
| Blue Shield - Ny Highmark Northeastern | $203 | 381% |
| Blue Shield - Ny Highmark Western | $203 | 381% |
| Blue Shield - Pa (Highmark) | $203 | 381% |
| Blue Shield - Wa (Regence) | $203 | 381% |
| Healthcare Management Admin | $211 | 396% |