CMS Price Transparency Data
Blood test, thyroid (TSH)
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 84443 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 84443
- Insurance Median: $35
- Cash Discount Price: $69
- vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a Blood test, thyroid (TSH) at Saint Alphonsus Medical Center Ontario is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $16.8, this hospital’s rate is 2.08x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$69
Average discount available for prompt cash payment at this facility.
Insurance Median
$35
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$16.8
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $16.8 (100%)
Cash / Self-Pay: $69 (411%)
Insurance Median: $35 (208%)
Cash: $69 (411% of Medicare)
Ins. Median: $35 (208% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $16.8 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 208% of the Medicare baseline (a markup of 108%). 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 |
|---|---|---|
| Medicaid / KanCare | $12 - $35 | 71% |
| Blue Cross Blue Shield | $16 - $99 | 95% |
| Medicare (plans) | $16 - $18 | 95% |
| UnitedHealthcare | $16 - $112 | 95% |
| Aetna | $17 - $111 | 101% |
| American Health Advantage Of Idaho | $17 | 101% |
| Healthnet | $18 | 107% |
| Healthcare Management Admin | $28 | 167% |
| Ada County Jail Inmate Ins | $29 - $35 | 173% |
| Ambetter / Centene | $29 - $35 | 173% |
| Amish Mennonite | $29 - $35 | 173% |
| Bcccp-Michigan | $29 - $35 | 173% |
| Bccp | $29 - $35 | 173% |
| Blue Benefit Administrators Of Massachusetts | $29 | 173% |
| Blue Care Network | $29 | 173% |
| Blue Distinction Transplant | $29 | 173% |
| Blue Shield - Ca | $29 | 173% |
| Blue Shield - Id (Regence) | $29 | 173% |
| Blue Shield - Ny Highmark Northeastern | $29 | 173% |
| Blue Shield - Ny Highmark Western | $29 | 173% |
| Blue Shield - Pa (Highmark) | $29 | 173% |
| Blue Shield - Wa (Regence) | $29 | 173% |
| Bmc Healthnet | $29 - $35 | 173% |
| Breast Grant-Connecticut | $29 - $35 | 173% |
| California Health And Wellness | $29 - $35 | 173% |
| Cardinal Innovations Lme | $29 - $35 | 173% |
| Care Oregon Ohp | $29 - $35 | 173% |
| Cencal Health Plan | $29 - $35 | 173% |
| Cenpatico | $29 - $35 | 173% |
| Centurion Of Idaho | $29 - $35 | 173% |
| Chhuny | $29 - $35 | 173% |
| Childrens Comm Health Plan | $29 - $35 | 173% |
| Childrens Medical Services Title 19 | $29 - $35 | 173% |
| Cigna | $29 - $110 | 173% |
| Community Benefit Health | $29 - $35 | 173% |
| Community Care Behavorial Health | $29 - $35 | 173% |
| Community Health Choice | $29 - $35 | 173% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $29 - $35 | 173% |
| Dean Wi Badgercare | $29 - $35 | 173% |
| Delaware First Health | $29 - $35 | 173% |
| Delta Dental Nj | $29 - $35 | 173% |
| Dph Tb Program | $29 - $35 | 173% |
| Dscc | $29 - $35 | 173% |
| Eastpointe Lme | $29 - $35 | 173% |
| Family Health Network | $29 - $35 | 173% |
| Freedom First Healthcare | $29 - $35 | 173% |
| Ghc Scw Wi Badgercare | $29 - $35 | 173% |
| Harbor Health | $29 - $35 | 173% |
| Health Safety Net | $29 - $35 | 173% |
| Healthy Blue Ne | $29 - $35 | 173% |
| Hennepin Health | $29 - $35 | 173% |
| Humana | $29 - $103 | 173% |
| Id County Ada | $29 - $35 | 173% |
| Id County Canyon | $29 - $35 | 173% |
| Id County Cat Fund | $29 - $35 | 173% |
| Id County Payette | $29 - $35 | 173% |
| Idaho Womens Health Check | $29 - $35 | 173% |
| Indiana Breast Cervical Cancer | $29 - $35 | 173% |
| Inland Empire Health Plan | $29 - $35 | 173% |
| Intercommunity Health Ohp | $29 - $35 | 173% |
| Iowa Total Care | $29 - $35 | 173% |
| Jai Medical System | $29 - $35 | 173% |
| Kern Family Health Plan | $29 - $35 | 173% |
| Keystone First | $29 - $35 | 173% |
| Keystone First Chip | $29 - $35 | 173% |
| La Care Health Plan | $29 - $35 | 173% |
| Lakeland Care Inc | $29 - $35 | 173% |
| Managed Health Services - Indiana | $29 - $35 | 173% |
| Maryland Breast & Cervical Program | $29 - $35 | 173% |
| Maryland Healthy Smiles - Scion Dental | $29 - $35 | 173% |
| Maryland Physicians Care | $29 - $35 | 173% |
| Massachusetts Behavioral Health Partnership | $29 - $35 | 173% |
| Mdwise | $29 - $35 | 173% |
| Medi-Cal | $29 - $35 | 173% |
| Medi-Cal Healthnet | $29 - $35 | 173% |
| Medstar Dc Healthy Family | $29 - $35 | 173% |
| Medstar Md Health Choice | $29 - $35 | 173% |
| Mo Home State Health Plan | $29 - $35 | 173% |
| Molina Centennial Care | $29 - $35 | 173% |
| Nascentia Health Options | $29 - $35 | 173% |
| Nebraska Total Care | $29 - $35 | 173% |
| New York Cancer Services Program | $29 - $35 | 173% |
| Nextlevel Health | $29 - $35 | 173% |
| Oregon Screenwise | $29 - $35 | 173% |
| Pace Of Southwest Michigan | $29 - $35 | 173% |
| Paramount Advantage | $29 - $35 | 173% |
| Parkland Community Health Plan | $29 - $35 | 173% |
| Partners Behavioral Lme | $29 - $35 | 173% |
| Peach State Healthplan | $29 - $35 | 173% |
| Presbyterian Centennial Care | $29 - $35 | 173% |
| Prestige Health Choice | $29 - $35 | 173% |
| Priority Partners | $29 - $35 | 173% |
| Rx 340B Pass Along | $29 - $35 | 173% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $29 - $35 | 173% |
| Rx Medi-Cal | $29 - $35 | 173% |
| Rx Meridian Rx | $29 - $35 | 173% |
| Sandhills Center Lme | $29 - $35 | 173% |
| Screening For Life | $29 - $35 | 173% |
| Sunshine State Health Plan | $29 - $35 | 173% |
| Superior Health | $29 - $35 | 173% |
| Tenncare | $29 - $35 | 173% |
| Texas Children'S Health Plan | $29 - $35 | 173% |
| Trillium Community Ohp | $29 - $35 | 173% |
| Tufts Health Public Plans | $29 - $35 | 173% |
| Vaya Health Lme | $29 - $35 | 173% |
| Wellsense Health Plan | $29 - $35 | 173% |
| Wi Womens Wellness | $29 - $35 | 173% |
| Moda Health | $33 - $113 | 196% |
| Webtpa | $44 - $105 | 262% |
| Mountain Health Co-Op | $58 - $70 | 345% |
| Pacificsource Health Plans | $58 - $110 | 345% |
| Selecthealth | $59 - $105 | 351% |
| Allegiance | $73 - $89 | 435% |
| Correctional Health Partners | $75 - $91 | 446% |
| Columbia Health Network | $77 - $94 | 458% |
| Allied National Global Care | $86 - $105 | 512% |
| Asrm - Reliance Standard Life Insurance | $86 - $105 | 512% |
| Christian Care Ministry | $86 - $105 | 512% |
| Dean Health | $86 - $105 | 512% |
| Fallon Health | $86 - $105 | 512% |
| Family Life Insurance Company | $86 - $105 | 512% |
| First Choice Health | $86 - $105 | 512% |
| Ghc Scw | $86 - $105 | 512% |
| International Benefit Administrators | $86 - $105 | 512% |
| Lifetime Benefit Solutions | $86 - $105 | 512% |
| Manhattan Life | $86 - $105 | 512% |
| Pai | $86 - $105 | 512% |
| Pan-American Life | $86 - $105 | 512% |
| Paramount Hmo | $86 - $105 | 512% |
| Phcs | $86 - $105 | 512% |
| Trinity Health Share | $86 - $105 | 512% |
| Lifewise | $89 - $109 | 530% |
| Priority Health | $90 - $110 | 536% |
| Allied Benefit Systems | $91 - $111 | 542% |
| Ameriben | $91 - $111 | 542% |
| Asr Health Benefits | $91 - $111 | 542% |
| Christian Brother Services | $91 - $111 | 542% |
| First Health | $91 - $111 | 542% |
| Geha | $91 - $112 | 542% |
| Healthez | $91 - $111 | 542% |
| Luminare Health (Detroit) | $91 - $111 | 542% |
| Medi Share | $91 - $111 | 542% |
| Providence | $91 - $111 | 542% |
| Rural Carrier Health Benefit Plan | $91 - $111 | 542% |