CMS Price Transparency Data
Blood antibody screen
Facility: San Gabriel Valley Medical Center
Billing Code: 86850 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86850
- Insurance Median: $66
- Cash Discount Price: $77
- vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at San Gabriel Valley Medical Center is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.24x the Medicare baseline. Located in 438 W Las Tunas Drive, San Gabriel, CA.
Cash / Self-Pay
$77
Average discount available for prompt cash payment at this facility.
Insurance Median
$66
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: $77 (145%)
Insurance Median: $66 (124%)
Cash: $77 (145% of Medicare)
Ins. Median: $66 (124% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ahmc Medi-Cal Reciprocity | $3 | 6% |
| Allied Physicians | $3 - $101 | 6% |
| Altamed Health Network | $3 - $66 | 6% |
| Beverly Hospital | $3 - $74 | 6% |
| Blue Cross Blue Shield | $3 - $287 | 6% |
| Brand New Day | $3 - $169 | 6% |
| Emanate Health | $3 - $84 | 6% |
| Healthnet Medi-Cal Non-Contract | $3 | 6% |
| Healthy Way La | $3 | 6% |
| La Care Health Plan | $3 - $67 | 6% |
| Non Contracting Medi Cal | $3 | 6% |
| Care 1St Health Plan | $4 - $313 | 8% |
| Aids Healthcare Foundation | $10 - $193 | 19% |
| Avanti | $10 - $80 | 19% |
| Hollywood Presbyterian Adv Med Mcal | $10 | 19% |
| Hollywood Presbyterian Medpoint Mcal | $10 | 19% |
| Medicaid / KanCare | $10 | 19% |
| Physicians Healthways | $10 - $67 | 19% |
| Cigna | $11 | 21% |
| Ahmc Reciprocity | $15 - $145 | 28% |
| Pacificare Of California | $17 - $158 | 32% |
| Alignment Healthplan | $18 - $169 | 34% |
| Clever Care | $18 - $169 | 34% |
| Molina Healthcare Of California | $20 - $188 | 38% |
| Pacific Independent Physician Associates | $20 - $193 | 38% |
| UnitedHealthcare | $20 - $39 | 38% |
| Aetna | $25 - $97 | 47% |
| Health Net | $25 - $280 | 47% |
| Facey Medical | $26 - $241 | 49% |
| Central Health Plan | $31 - $289 | 58% |
| Private Pay | $32 | 60% |
| Community Care Network | $33 - $313 | 62% |
| Choicecare Network | $36 - $337 | 68% |
| Private Healthcare Systems (Phcs) | $36 - $337 | 68% |
| Affiliated Health Fund | $38 - $362 | 71% |
| Beech Street | $41 - $386 | 77% |
| Multiplan | $46 - $434 | 86% |
| Ppo Next | $46 - $434 | 86% |
| Veterans Administration | $47 | 88% |
| Athens Administrators | $51 - $89 | 96% |
| Managed Health Network | $51 - $482 | 96% |
| Medi-Cal Sub Acute | $51 - $482 | 96% |
| One Legacy | $51 - $482 | 96% |
| Other Non Contracted Commercial | $51 - $482 | 96% |
| Other Non Contracting Workers Comp | $51 - $89 | 96% |
| Us Behavioral Health Plan | $51 - $482 | 96% |
| Alignment Health Plan | $66 | 124% |
| Apa/Aco Inc | $66 | 124% |
| Blue Shield Of California | $66 - $192 | 124% |
| Health Net Inc | $66 - $156 | 124% |
| Humana | $66 | 124% |
| Medicare (plans) | $66 - $69 | 124% |
| Pacific Alliance Medical Center | $66 | 124% |
| Providence Health Network | $66 | 124% |
| Tricare | $66 | 124% |
| Wellcare | $66 | 124% |
| Cv-19 Hrsa Uninsured Testing And Tx | $67 | 126% |
| Inter Valley Health Plan | $67 | 126% |
| Self-Pay | $67 | 126% |
| St Vincent Medical Center/Psych | $67 | 126% |
| Chinatown Service Center Pace | $79 | 148% |
| Ahmc Health Self-Insurance Epo | $84 | 158% |
| Knox-Keene Act | $84 | 158% |