CMS Price Transparency Data

Blood antibody screen

Facility: Sherman Oaks Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $67
Cash Discount Price: $66
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Sherman Oaks Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.26x the Medicare baseline. Located in 4929 Van Nuys Blvd, Sherman Oaks, CA.

Cash / Self-Pay

$66

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $66 (124%)

Insurance Median: $67 (126%)

Cash: $66 (124% of Medicare)

Ins. Median: $67 (126% 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
Aids Healthcare Foundation	$3 - $68	6%
Blue Shield Of Promise	$3	6%
Health Net Of Ca	$3 - $97	6%
L.A Care Health Plan	$3 - $67	6%
Molina	$3 - $67	6%
Traditional Medi-Cal	$3	6%
Blue Cross Blue Shield	$14	26%
Alignment	$67	126%
Blue Shield Of Ca, Va	$67	126%
Brand New Day	$67 - $100	126%
Elite Health Plan	$67	126%
Imperial Health Plan	$67	126%
Managed Health Network	$67	126%
Medicare (plans)	$67	126%
Renal Payer Solutions	$67	126%
Tricare	$67	126%
Usa Senior Care Network	$67	126%
Corvel	$76	143%
Zelis Healthcare	$76	143%
Americas Choice Provider Network	$78	147%
Healthsmart Preferred Network	$78	147%
Multiplan	$78	147%
Prime Health Services	$78	147%
Three Rivers	$78	147%
Provider Select	$79	148%
Provider Network Of America	$80	150%
Aetna	$85	160%
Ca Foundation For Medical Center	$86 - $88	162%
Employer Direct Healthcare	$86 - $93	162%
Naphcare	$86 - $103	162%
Worker Comp	$86 - $88	162%

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 $66.
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 Sherman Oaks 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.