CMS Price Transparency Data

Blood antibody screen

Facility: Los Robles Hospital & Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $13
Cash Discount Price: $47
vs. Medicare Baseline: 0.24x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Los Robles Hospital & Medical Center is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.24x the Medicare baseline. Located in 215 W Janss Rd, Thousand Oaks, CA.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $47 (88%)

Insurance Median: $13 (24%)

Cash: $47 (88% of Medicare)

Ins. Median: $13 (24% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$2 - $726	4%
Medcare Partners	$2 - $109	4%
United	$3 - $204	6%
Brand New Day	$4 - $10	8%
Gold Coast Health Plan	$4	8%
Health Net	$5 - $296	9%
First Health	$8 - $581	15%
Choicecare Network	$9 - $508	17%
Alignment Health Plan	$10	19%
Blue Cross Blue Shield	$10 - $51	19%
Blue Shield	$10 - $319	19%
Care1St Health Plan	$10	19%
Central Health Plan	$10	19%
Clever Care Of Golden State	$10	19%
Easy Choice Health Plan	$10	19%
Facey Medical Group	$10 - $13	19%
Humana	$10	19%
La Care	$10	19%
Multiplan	$10 - $690	19%
Ppo Next	$10 - $581	19%
Scan Health Plan	$10	19%
Triwest Healthcare Alliance	$10	19%
Corvel Corporation	$11	21%
Interplan Corporation	$11 - $653	21%
Ventura County Foundation	$11 - $653	21%
Bright Health	$24	45%
Cigna	$34	64%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $47.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86850.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Los Robles Hospital & Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86850.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.