CMS Price Transparency Data

Blood antibody screen

Facility: Southwest Healthcare Rancho Springs Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $36
Cash Discount Price: $85
vs. Medicare Baseline: 0.68x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Southwest Healthcare Rancho Springs Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.68x the Medicare baseline. Located in 25500 Medical Center Drive, Murrieta, CA.

Cash / Self-Pay

$85

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $85 (160%)

Insurance Median: $36 (68%)

Cash: $85 (160% of Medicare)

Ins. Median: $36 (68% 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
Health_Net	$2 - $128	4%
Kaiser	$2 - $111	4%
Heritage	$3 - $144	6%
United_Healthcare	$3 - $12	6%
Iehp	$4	8%
Blue Cross Blue Shield	$14 - $236	26%
Cigna	$19 - $135	36%
Primecare	$21 - $149	39%
Palomar	$24 - $176	45%
Rady_Children'S_Hospital	$36 - $262	68%
Multiplan	$47 - $338	88%
Sharp_Health_Plan	$47 - $338	88%
Aetna	$75	141%

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 $85.
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 Southwest Healthcare Rancho Springs Hospital 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.