CMS Price Transparency Data

Blood antibody screen

Facility: El Centro Regional Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $82
Cash Discount Price: $79
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at El Centro Regional Medical Center is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.54x the Medicare baseline. Located in 1415 Ross Avenue, El Centro, CA.

Cash / Self-Pay

$79

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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: $79 (148%)

Insurance Median: $82 (154%)

Cash: $79 (148% of Medicare)

Ins. Median: $82 (154% 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
Blue Cross Blue Shield	$10 - $83	19%
Brand New Day Comm - All Other Plans	$10	19%
Brand New Day Mcr	$10	19%
Healthnet Mcr Adv	$10	19%
Molina Mcr Adv	$10	19%
Scp Managed Care - All Plans	$10	19%
Tricare	$10	19%
UnitedHealthcare	$10 - $63	19%
Easy Choice Mcr Adv-All Plans	$11	21%
Healthnet Hmo	$12	23%
Cdcr Correctional-All Plans	$13	24%
Aetna	$44 - $55	83%
Blue Shield-All Plans	$44	83%
Pacificare-All Plans	$62 - $78	116%
Mulitplan Primary - All Other Plans	$68 - $86	128%
Cigna	$75 - $94	141%
Multiplan Comp	$80 - $101	150%
Trident - All Plans	$85 - $107	160%
Healthnet Comm-All Other Plans	$90 - $113	169%
Humana	$93 - $117	175%
Ahccs/Medi-Cal Misc - All Plans	$100 - $126	188%
Brand New Day Mcal	$100 - $126	188%
Medi-Cal	$100 - $126	188%
Molina Exchange - All Other Plans	$100 - $126	188%
Ambetter / Centene	$103 - $130	193%
Molina Mcal	$110 - $139	207%

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 $79.
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 El Centro Regional Medical Center 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.