CMS Price Transparency Data

Blood antibody screen

Facility: San Gorgonio Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $70
Cash Discount Price: $41
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at San Gorgonio Memorial Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.31x the Medicare baseline. Located in 600 North Highland Springs Avenue, Banning, CA.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$70

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: $41 (77%)

Insurance Median: $70 (131%)

Cash: $41 (77% of Medicare)

Ins. Median: $70 (131% 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	$23 - $67	43%
Lasalle Medical Associates	$63	118%
Beaver Medical Group	$67	126%
Blue Shield	$67 - $213	126%
Choice Physicians Network	$67	126%
Heritage Provider Network	$67	126%
Inland Empire Health Plan	$67 - $73	126%
Kaiser	$67 - $200	126%
Providence Health Network	$67	126%
Redlands Community Hospital	$67 - $77	126%
UnitedHealthcare	$67	126%
Easy Choice Health Plan	$70	131%
Epic Management	$70	131%
Health Net	$73 - $96	137%
Velocity	$73	137%
Imperial Health Plan	$75	141%

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 $41.
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 San Gorgonio Memorial 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.