CMS Price Transparency Data

Blood antibody screen

Facility: Valley Presbyterian Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $37
Cash Discount Price: $41
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Valley Presbyterian Hospital is $37. 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 0.69x the Medicare baseline. Located in 15107 Vanowen St, Van Nuys, CA.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $37 (69%)

Cash: $41 (77% of Medicare)

Ins. Median: $37 (69% 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 Shield Promise Medi-Cal	$7 - $22	13%
Cigna	$13	24%
La Care Medi-Cal	$17 - $52	32%
Phcs	$17 - $52	32%
Aetna	$20 - $68	38%
Coventry Health Care (Ccn)	$20 - $61	38%
UnitedHealthcare	$21 - $68	39%
Beech Street	$22 - $65	41%
Multiplan	$26 - $78	49%
Blue Cross Blue Shield	$34 - $68	64%
Blue Shield Ifp	$64	120%
Blue Shield Senior	$67	126%
Health Net Senior	$68	128%
La Care Covered California	$68	128%
Medicare (plans)	$68 - $71	128%
Blue Shield	$76	143%
Ambetter / Centene	$96	180%
Heritage Provider Network (Regal & Lakeside)	$105	197%
Health Net	$134	252%

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 Valley Presbyterian 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.