CMS Price Transparency Data

Blood antibody screen

Facility: Loma Linda University Children's Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $72
Cash Discount Price: $146
vs. Medicare Baseline: 1.35x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Loma Linda University Children's Hospital is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.35x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $146 (274%)

Insurance Median: $72 (135%)

Cash: $146 (274% of Medicare)

Ins. Median: $72 (135% 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
Inland Empire Health Plan (Iehp)	$4 - $10	8%
Kaiser Foundation Hospitals	$5 - $267	9%
UnitedHealthcare	$8	15%
Alpha Care Medical Group	$10 - $15	19%
Dignity Health	$10 - $15	19%
Epic Health Plan	$10 - $160	19%
Upland Medical Group	$10	19%
Vantage Medical Group	$10 - $15	19%
Molina Healthcare Of Ca	$12 - $13	23%
Heritage Provider Network	$16	30%
Adventist Health	$22 - $80	41%
Lluh Dept Of Risk Management	$27 - $96	51%
Blue Shield Of California	$49 - $268	92%
Global Benefits Group	$67 - $241	126%
Temecula Valley Physicians Medical Group	$67 - $241	126%
Trivalley Medical Group	$67 - $241	126%
Cigna	$71 - $297	133%
Networks By Design	$72 - $261	135%
Aetna	$73 - $263	137%
Multiplan	$89 - $321	167%
Galaxy Health	$94 - $341	177%
Prime Health Services	$94 - $341	177%
Blue Cross Blue Shield	$107	201%

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 $146.
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 Loma Linda University Children's 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.