CMS Price Transparency Data
Blood antibody screen
Facility: Greater El Monte Community Hospital
Billing Code: 86850 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86850
- Insurance Median: $66
- Cash Discount Price: $144
- vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Greater El Monte Community Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $144. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.24x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$144
Average discount available for prompt cash payment at this facility.
Insurance Median
$66
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: $144 (270%)
Insurance Median: $66 (124%)
Cash: $144 (270% of Medicare)
Ins. Median: $66 (124% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Care 1St Medi Cal Hmo Cap Exceptional Care | $2 - $36 | 4% |
| Care First Health Plan | $2 - $36 | 4% |
| Aids Health Foundation | $3 - $66 | 6% |
| Allied Physicians Medical Group | $3 - $108 | 6% |
| Altamed Health Network | $3 - $66 | 6% |
| Avanti | $3 - $80 | 6% |
| Beverly Hospital | $3 - $74 | 6% |
| Blue Cross Blue Shield | $3 - $180 | 6% |
| Brand New Day | $3 - $84 | 6% |
| Clinica Medica Familiar | $3 - $180 | 6% |
| Emanate Health | $3 - $84 | 6% |
| Health Net Foundation | $3 - $235 | 6% |
| Healthy Way La | $3 | 6% |
| La Care Health Plan | $3 - $199 | 6% |
| Other Non Contracted Medi-Cal Hmo | $3 | 6% |
| State Of California | $3 | 6% |
| Caloptima | $4 | 8% |
| Bella Vista Medical Group Ipa | $5 - $162 | 9% |
| Employee Health Systems Medical Group | $5 - $72 | 9% |
| Global Care Medical Group Ipa | $5 - $162 | 9% |
| Alta Med Health Services Med Grp | $6 - $90 | 11% |
| Ahmc Reciprocity Agreement | $8 - $108 | 15% |
| Ahmc Reciprocity Agreement Senior/Commercial | $8 - $108 | 15% |
| Good Samaritan Medical Practice Assoc | $8 - $217 | 15% |
| Lincoln Hospital Medical Center | $8 - $108 | 15% |
| Allied Physicians | $10 - $99 | 19% |
| Associated Hispanic Physicians | $10 - $60 | 19% |
| Hollywood Presbyterian Adv Med Mcal | $10 | 19% |
| Hollywood Presbyterian Medpoint Mcal | $10 | 19% |
| Molina Healthcare Of California | $10 - $141 | 19% |
| Cigna | $11 | 21% |
| Blue Shield Of California | $12 - $190 | 23% |
| California Thoroughbred Horesmans Foundation | $12 - $180 | 23% |
| Universal Care | $12 - $253 | 23% |
| Care 1St Health Plan | $15 - $217 | 28% |
| Cost Containment Strategies | $16 - $235 | 30% |
| In Custody Police Dept | $16 - $235 | 30% |
| Interplan | $16 - $271 | 30% |
| Central Health Plan | $17 - $253 | 32% |
| Health Net Inc | $18 - $256 | 34% |
| UnitedHealthcare | $18 - $310 | 34% |
| Community Care Network | $20 - $289 | 38% |
| In Custody-Ca Highway Patrol | $20 | 38% |
| Multiplan | $21 - $307 | 39% |
| Health Payors Organization | $22 - $325 | 41% |
| Pacificare Of California | $22 - $313 | 41% |
| Athens Administrators | $25 - $89 | 47% |
| Commercial Non Contract | $25 - $361 | 47% |
| Intercomp | $25 - $80 | 47% |
| Medi-Cal Sub Acute | $25 - $361 | 47% |
| Nuclear Medicine/Whmc | $25 - $361 | 47% |
| One Legacy | $25 - $361 | 47% |
| Other Non Contracted Work Comp | $25 - $89 | 47% |
| Preferred Health Network | $25 - $85 | 47% |
| Veterans Administration | $47 | 88% |
| Apa/Aco Inc | $66 | 124% |
| Cms | $66 | 124% |
| Easy Choice Health Plan | $66 | 124% |
| Other Non Contracted Senior Hmo | $66 | 124% |
| Pacific Alliance Medical Center Reciprocal Contract | $66 | 124% |
| Scan Health Plan | $66 | 124% |
| Champus Foundation | $67 | 126% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $67 | 126% |
| La Care Covered Direct | $67 | 126% |
| Self-Pay | $67 | 126% |
| Alignment Health Plan | $69 | 130% |
| Molina Healthcare | $69 | 130% |
| Inter Valley Health Plan | $70 | 131% |
| San Miguel Health Plan | $74 | 139% |
| Chinatown Service Center Pace | $79 | 148% |
| Ahmc Health Self-Insurance Epo | $84 | 158% |
| Knox-Keene Act | $84 | 158% |