CMS Price Transparency Data

Drug screening test

Facility: West Valley Medical Center

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $226
Cash Discount Price: $404
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Drug screening test at West Valley Medical Center is $226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $404. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 1.98x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$404

Average discount available for prompt cash payment at this facility.

Insurance Median

$226

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$114.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $114.43 (100%)

Cash / Self-Pay: $404 (353%)

Insurance Median: $226 (198%)

Cash: $404 (353% of Medicare)

Ins. Median: $226 (198% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $114.43 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
Molina	$99 - $114	87%
Blue Cross Blue Shield	$99 - $12,015	87%
Veteran's Administration	$114	100%
Humana	$114 - $339	100%
St Luke's Health Partners	$114	100%
United	$114 - $241	100%
Regence Blue Shield	$114	100%
Select Health Idaho (Eirmc Only)	$129	113%
Corizon Health	$149	130%
True Blue	$160	140%
Cigna	$226	198%
Regence	$236	206%
Pacificsource Health	$241	211%
Moda	$252	220%
Aetna	$319	279%
Multiplan	$323	282%
Four Rivers Hospice	$323	282%
Geha PPO USA	$343	300%
Coventry First Health	$364	318%
St Alphonsus Health	$364	318%

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 $404.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0480.

Insurance In-Network Protection Plan

Contact your insurance company to confirm West Valley Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0480.
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.