CMS Price Transparency Data

Blood antibody screen

Facility: Adventist Health Sonora

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $95
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Adventist Health Sonora is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.78x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $20 (38%)
Insurance Median: $95 (178%)
Cash: $20 (38% of Medicare)
Ins. Median: $95 (178% 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
Central Ca Alliance Ccs Mcal $4 8%
Central Ca Alliance Chdp Mcal $4 8%
Central Ca Alliance Mcal $4 8%
Medi-Cal $4 8%
Celtic Ca Hlth Well Mcal - All Plans $5 9%
Kaiser - All Plans $5 - $177 9%
UnitedHealthcare $5 - $304 9%
Western Growers/Pinnacle - All Plans $5 - $188 9%
Healthnet Mcal $6 11%
Blue Shield - All Other Plans $7 - $269 13%
Blue Shield Epn $7 - $268 13%
Beech Street- All Plans $8 - $301 15%
Greatwest Oa/Pos/Hmo $8 - $301 15%
Trpn - Three Rivers Ppo - All Plans $8 - $283 15%
Affordable Health - All Plans $9 - $319 17%
Cigna $9 - $336 17%
Greatwest Ppo - All Other Plans $9 - $319 17%
Healthnet - All Other Plans $9 - $310 17%
Interplan - All Plans $9 - $319 17%
Multiplan - All Plans $9 - $319 17%
Phcs Ppo - All Plans $9 - $319 17%
Stanilaus Foundation - All Plans $9 - $336 17%
Aetna $10 - $167 19%
Blue Shield Mcare $10 19%
Healthnet Mcr Adv $10 19%
Phs Prime Health Srvcs-All Plans $10 19%
Tricare $10 19%
Ah Employee Health Plan - All Plans $18 34%
Bc Exchange $98 184%
Bc Non-Mcs - All Other Plans $109 205%
Bc Mcs $131 246%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Greenley Road, Sonora, CA 95370
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals