CMS Price Transparency Data

Blood antibody screen

Facility: AHMC Seton Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $81
  • Cash Discount Price: $126
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at AHMC Seton Medical Center is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.52x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
$126

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

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: $126 (237%)
Insurance Median: $81 (152%)
Cash: $126 (237% of Medicare)
Ins. Median: $81 (152% 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
Blue Cross Blue Shield $3 - $182 6%
Medi-Cal $3 6%
San Mateo County/San Mateo County General Hospital $3 6%
Jade Health Care Mg $4 - $120 8%
North East Medical Services $4 - $74 8%
San Francisco Health Plan $4 8%
Cmac $10 19%
Hill Physicians Medical Group Inc $10 - $87 19%
Kaiser $10 - $196 19%
Asian American Medical Group $12 - $95 23%
Brown And Toland Medical Group $12 - $95 23%
Health Plan Of San Mateo Healthworx $12 23%
Health Plan Of San Mateo $14 26%
Self Pay $16 - $81 30%
UnitedHealthcare $20 - $76 38%
Aetna $50 - $74 94%
Veterans Administration (Va) $53 100%
Chinese Community Health Plan $54 - $120 101%
Cigna $55 103%
Blue Shield Of California $57 - $250 107%
Interplan Corporation $65 - $143 122%
Brand New Day $74 - $95 139%
Care Advantage $74 139%
For Your Benefit $74 139%
Healthnet Seniority $74 139%
Humana $74 139%
Imperial Health Plan $74 139%
Medicare (plans) $74 139%
Pacificare $74 139%
Tricare $75 141%
Apcmg $76 - $113 143%
Canopy Health $76 - $136 143%
Covid-19 Uninsured Program $76 143%
Healthcare Foundation Of San Mateo $76 - $179 143%
Easy Choice Hospital Services $77 145%
Central Health Plan $80 150%
Multiplan/Bce Emergis $81 - $179 152%
Private Healthcare Sytems Inc $81 - $179 152%
The First Health Network $81 - $179 152%
Health Net $83 - $183 156%
Beech Street Corporation $86 - $191 162%
Choicecare Network $92 - $203 173%
Multiplan $92 - $203 173%
Ahmc Health $95 178%
Knox-Keene Act $95 178%
Mills Peninsula Health Services $97 - $215 182%
Athens Administrators $101 190%
Corvel Healthcare $101 190%
Work Comp Other $101 190%
Indemnity $108 - $239 203%
Workers Compensation Federal $108 - $239 203%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals