CMS Price Transparency Data

Blood antibody screen

Facility: Adventist Health Vallejo

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $86
Cash Discount Price: $30
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Adventist Health Vallejo is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.62x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

$30

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $30 (56%)

Insurance Median: $86 (162%)

Cash: $30 (56% of Medicare)

Ins. Median: $86 (162% 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
Medi-Cal	$4	8%
Va Medi-Cal	$4	8%
Blue Shield Mcr Adv	$10	19%
Medicare (plans)	$10	19%
Napa County Mcal Child	$10	19%
Tricare	$10	19%
UnitedHealthcare	$10 - $184	19%
Va Mcr-All Other Plans	$10	19%
Healthnet-All Plans	$11 - $28	21%
Ah Employee Health Plan-All Plans	$18	34%
Blue Shield Behav Hlth	$49 - $130	92%
Blue Shield Non-Epn-All Other Plans	$50 - $134	94%
Blue Shield Epn	$51 - $136	96%
Western Growers-All Plans	$57 - $153	107%
Phcs-All Plans	$59 - $158	111%
Interplan-All Plans	$70 - $187	131%
Choicecare-All Plans	$76 - $202	143%
Beech Street-All Plans	$81 - $216	152%
Aetna	$86	162%
Cigna	$86 - $230	162%
Kaiser-All Plans	$91 - $242	171%
Health Management Network-All Plans	$92 - $245	173%
Galaxy Network-All Plans	$97 - $259	182%
Three Rivers-All Plans	$97 - $259	182%
Blue Cross Blue Shield	$104 - $125	195%

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 $30.
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 Vallejo 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.