CMS Price Transparency Data

Blood antibody screen

Facility: Garden Grove Hospital & Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $67
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Garden Grove Hospital & Medical Center is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.26x the Medicare baseline. Located in 12601 Garden Grove Blvd, Garden Grove, CA.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$67

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: $66 (124%)
Insurance Median: $67 (126%)
Cash: $66 (124% of Medicare)
Ins. Median: $67 (126% 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.

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
Caloptima $3 6%
Health Net Of Ca $3 - $97 6%
Molina $3 - $67 6%
Traditional Medi-Cal $3 6%
Blue Shield Of Ca $67 126%
Brand New Day $67 - $100 126%
Central Health Plan $67 126%
Innovative Mgmt Svcs $67 126%
Medcare Partners Health Plan $67 126%
Medicare (plans) $67 126%
Patient Choice Health Plan $67 126%
Renal Payer Solutions $67 126%
Tricare $67 126%
Verda Healthplan $67 126%
Imperial Health Plan Of Ca $71 133%
Aetna $85 160%
Workers Compensation $88 165%
Employer Direct Healthcare $93 175%
Naphcare $103 193%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12601 Garden Grove Blvd, Garden Grove, CA 92843
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals