CMS Price Transparency Data

Blood antibody screen

Facility: Grossmont Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $44
Cash Discount Price: $117
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Grossmont Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.83x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$117

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $117 (220%)

Insurance Median: $44 (83%)

Cash: $117 (220% of Medicare)

Ins. Median: $44 (83% 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.

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
Aetna	$1 - $211	2%
Community Health Group	$1 - $180	2%
Health Net	$1 - $206	2%
Managed Health Network	$1	2%
Medicare (plans)	$1 - $38	2%
UnitedHealthcare	$8 - $3,999	15%
Indian Health Council	$15 - $26	28%
Blue Cross Blue Shield	$16 - $180	30%
Kaiser	$26 - $120	49%
San Diego Pace	$31 - $172	58%
Cigna	$33 - $44	62%
Molina	$33 - $180	62%
Humana	$34 - $180	64%
Blue Shield	$35 - $157	66%
Allianz Global Assistance	$38 - $87	71%
County Medical Services	$38 - $87	71%
Interplan	$41 - $206	77%
California Health And Wellness	$154	289%
Medi-Cal	$180 - $206	338%
Epic Americas	$193	363%

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 $117.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86850.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86850.
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.