CMS Price Transparency Data
Blood antibody screen
Facility: Garfield Medical Center
Billing Code: 86850 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86850
- Insurance Median: $30
- Cash Discount Price: $48
- vs. Medicare Baseline: 0.56x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Garfield Medical Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.56x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$48
Average discount available for prompt cash payment at this facility.
Insurance Median
$30
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: $48 (90%)
Insurance Median: $30 (56%)
Cash: $48 (90% of Medicare)
Ins. Median: $30 (56% 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 |
|---|---|---|
| Pacific Independent Physician Association | $2 - $10 | 4% |
| Access Ipa Ancillary | $3 - $20 | 6% |
| Ahmc Healthcare Inc | $3 - $20 | 6% |
| Allied Physicians | $3 - $101 | 6% |
| Associated Hispanic Phys Of So Cal | $3 - $13 | 6% |
| Beverly Hospital | $3 - $74 | 6% |
| Blue Cross Blue Shield | $3 - $135 | 6% |
| Brand New Day | $3 - $84 | 6% |
| Care 1St Mcl/Gar Cap Reciprocity | $3 | 6% |
| Care First Health Plan | $3 - $6 | 6% |
| Community Health Plan | $3 | 6% |
| Emanate Health | $3 - $84 | 6% |
| Health Net | $3 - $117 | 6% |
| Healthy Way La | $3 | 6% |
| La Care Health Plan | $3 - $66 | 6% |
| Other Non-Contracting Medi-Cal | $3 | 6% |
| Physicians Healthways Medi-Cal | $3 - $65 | 6% |
| UnitedHealthcare | $3 - $66 | 6% |
| Employee Health Systems Mg | $6 - $13 | 11% |
| Family Health Alliance | $9 - $20 | 17% |
| Aids Health Foundation | $10 - $66 | 19% |
| Allied Physicians Risk Pool | $10 - $23 | 19% |
| Allied Physicians Risk Pool Agreement | $10 - $23 | 19% |
| Avanti | $10 - $80 | 19% |
| Healthnet Medi Cal Cap | $10 - $23 | 19% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $10 | 19% |
| Hollywood Presbyterian Medpoint Mcal | $10 | 19% |
| Pipa Risk Pool Agreement | $10 - $23 | 19% |
| State Of California Medi-Cal | $10 | 19% |
| Cigna | $11 | 21% |
| Physician Healthways Medical Corporation | $11 | 21% |
| Central Health Plan | $12 - $66 | 23% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $12 - $26 | 23% |
| Health Net Foundation M Cal (Family Health Alliance) | $12 - $26 | 23% |
| Molina Medical Group | $12 - $25 | 23% |
| Phys Assoc Of San Gab Valley | $12 - $26 | 23% |
| Caloptima Direct | $14 | 26% |
| Allied Physicians Med Grp | $15 - $32 | 28% |
| Blue Shield Of California | $15 - $172 | 28% |
| Health Net Comm/Hmo | $16 - $106 | 30% |
| Alhambra Hospital | $18 - $39 | 34% |
| Care 1St Health Plan | $18 - $39 | 34% |
| Interplan | $18 - $65 | 34% |
| Pacificare Of California Inc | $20 | 38% |
| Pacificare Ppo | $20 | 38% |
| First Health Network | $21 - $67 | 39% |
| One Health Plan | $21 - $46 | 39% |
| Aetna | $22 - $66 | 41% |
| Fmc Los Angeles Co Epo | $22 - $49 | 41% |
| Corvel Corporation | $24 - $52 | 45% |
| Americas Health Plan | $26 - $55 | 49% |
| Multiplan | $26 - $65 | 49% |
| Health Payors Organization | $27 - $58 | 51% |
| Advantage Care Ipa | $30 - $67 | 56% |
| Athens Administrators | $30 - $65 | 56% |
| East La Reg Ctr | $30 - $65 | 56% |
| Non Contract Commercial | $30 - $65 | 56% |
| One Legacy | $30 - $65 | 56% |
| Other Non-Contracted Workers Compensation | $30 - $65 | 56% |
| Physicians Healthways Medical Corporation | $30 - $66 | 56% |
| Preferred Health Network | $30 - $65 | 56% |
| Private Pay | $30 - $65 | 56% |
| Veterans Administration | $47 | 88% |
| Apa Aco Inc | $66 | 124% |
| Blue Shield | $66 - $192 | 124% |
| Cms | $66 | 124% |
| Easy Choice Health Plan | $66 | 124% |
| Humana | $66 | 124% |
| Non-Contract Medi-Care | $66 | 124% |
| Pacific Alliance Medical Center Comm/Sr | $66 | 124% |
| Cv-19 Hrsa Uninsured Testing And Tx | $67 | 126% |
| La Care Covered Direct | $67 | 126% |
| Scan Health Plan Sr Hmo | $67 | 126% |
| Self-Pay | $67 | 126% |
| Ucla Impact Dept Of Uncology | $67 | 126% |
| Alignment Health Plan | $69 | 130% |
| Molina Healthcare | $69 | 130% |
| Molina Healthcare Of California | $69 - $84 | 130% |
| Inter Valley Health Plan | $70 | 131% |
| National Disaster Medical System | $74 | 139% |
| San Miguel Health Plan | $74 | 139% |
| Chinatown Service Center Pace | $80 | 150% |
| Ahmc Health Epo | $84 | 158% |
| Knox-Keene Act | $84 | 158% |
| Health Net Inc | $109 | 205% |