CMS Price Transparency Data

Blood antibody screen

Facility: Good Samaritan Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $69
  • Cash Discount Price: $539
  • vs. Medicare Baseline: 1.30x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Good Samaritan Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $539. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.30x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.
Cash / Self-Pay
$539

Average discount available for prompt cash payment at this facility.

Insurance Median
$69

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: $539 (1012%)
Insurance Median: $69 (130%)
Cash: $539 (1012% of Medicare)
Ins. Median: $69 (130% 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
Physicians Medical Group $3 6%
Blue Cross Blue Shield $4 - $51 8%
Aetna $10 - $50 19%
Affinity Medical Group $10 19%
Alignment Health Plan $10 19%
Blue Shield $10 - $183 19%
Care1St Health Plan $10 19%
Central Health Plan $10 19%
Clever Care Of Golden State $10 19%
Easy Choice Health Plan $10 19%
Humana $10 - $685 19%
Managed Health Network $10 19%
On Lok Senior Health $10 19%
Palo Alto Medical $10 - $13 19%
Santa Clara Family Health Plan $10 - $186 19%
Scan Health Plan $10 19%
Triwest Healthcare Alliance $10 19%
United $10 - $250 19%
University Healthcare $10 19%
Vitality Health Plan $10 19%
Corvel Corporation $11 21%
Affinity Medical Group Comm $13 24%
Medcare Partners $14 - $147 26%
Canopy $18 34%
Bright Health $20 38%
Health Net $21 - $228 39%
Nx Health Network $54 - $587 101%
Sutter Select $54 - $587 101%
Multiplan $59 - $783 111%
First Health $69 - $979 130%
Cigna $72 - $783 135%
Healthsmart $72 - $783 135%
Intercontinental Corporation $72 - $783 135%
Pha Pacific Health Alliance $72 - $783 135%
Ppo Next $72 - $783 135%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2425 Samaritan Drive, San Jose, CA 95124
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals