CMS Price Transparency Data

Blood antibody screen

Facility: Adventist Health Tulare

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $66
Cash Discount Price: $27
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Adventist Health Tulare is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.24x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$27

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: $27 (51%)

Insurance Median: $66 (124%)

Cash: $27 (51% 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

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
Blue Cross Blue Shield	$3 - $110	6%
Blue Shield Epn	$3 - $68	6%
Blue Shield-All Other Plans	$4 - $94	8%
Dignity Mcal Op Only	$4	8%
Independence Op Only - All Plans	$4	8%
Medi-Cal	$4	8%
Western Growers - All Plans	$4 - $99	8%
Ccipa Medi-Cal - All Plans	$5	9%
Cigna	$5 - $100	9%
Healthnet Medi-Cal	$5	9%
Network By Design-All Plans	$6 - $140	11%
Hs Interplan-All Plans	$7 - $144	13%
UnitedHealthcare	$7 - $156	13%
Multiplan - All Plans	$8 - $183	15%
Blue Shield Mcare	$10	19%
Dignity Mcr Op Only - All Other Plans	$10	19%
Fhcn Pace Mcr Adv - All Plans	$10	19%
Medicare (plans)	$10	19%
Prime Health - All Plans	$10	19%
Tricare	$10	19%
Cal Forensic Med Grp - All Plans	$13	24%
Prison Hlthcre - All Plans	$13	24%
Bright Health - All Plans	$14	26%
Ah Employee Health Plan - All Plans	$18	34%
Incentive Hlth - All Plans	$18	34%
Healthnet Hmo/Ppo - All Other Plans	$26	49%
Aetna	$108	203%

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 $27.
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 Adventist Health Tulare 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.