CMS Price Transparency Data

Blood antibody screen

Facility: Adventist Health St Helena

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $81
  • Cash Discount Price: $17
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Adventist Health St Helena is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.52x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.
Cash / Self-Pay
$17

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

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: $17 (32%)
Insurance Median: $81 (152%)
Cash: $17 (32% of Medicare)
Ins. Median: $81 (152% 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.

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
Va Medi-Cal $4 8%
Blue Shield Bh Mcr Adv $10 19%
Blue Shield Mcr Adv $10 19%
Kaiser Mcr Adv $10 19%
Tricare $10 19%
UnitedHealthcare $10 - $184 19%
Va Mcr - All Other Plans $10 19%
Healthnet-All Plans $11 - $28 21%
Ah Employee Health Plan - All Plans $18 34%
Blue Shield Behav Hlth $49 - $130 92%
Blue Shield Non-Epn $50 - $134 94%
Blue Shield Epn-All Other Plans $51 - $136 96%
Western Growers-All Plans $57 - $153 107%
Phcs-All Plans $59 - $158 111%
Interplan-All Plans $70 - $187 131%
Choicecare-All Plans $76 - $202 143%
Beech Street-All Plans $81 - $216 152%
Aetna $86 162%
Cigna $86 - $230 162%
Kaiser-All Other Plans $89 - $236 167%
Health Management Network-All Plans $92 - $245 173%
Blue Cross Blue Shield $94 - $125 177%
Galaxy Network-All Plans $97 - $259 182%
Three Rivers-All Plans $97 - $259 182%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Woodland Road, Saint Helena, CA 94574
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals