CMS Price Transparency Data

Blood antibody screen

Facility: HCA Healthone Mountain Ridge

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $24
Cash Discount Price: $630
vs. Medicare Baseline: 0.45x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at HCA Healthone Mountain Ridge is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $630. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.45x the Medicare baseline. Located in 9191 Grant St, Thornton, CO.

Cash / Self-Pay

$630

Average discount available for prompt cash payment at this facility.

Insurance Median

$24

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: $630 (1183%)

Insurance Median: $24 (45%)

Cash: $630 (1183% of Medicare)

Ins. Median: $24 (45% 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
Cigna	$5 - $403	9%
Aetna	$10 - $333	19%
Blue Cross Blue Shield	$10 - $466	19%
Bright Health	$10 - $189	19%
Delaware Life Insurance	$10	19%
Devoted Health	$10	19%
Humana	$10	19%
Innovage Pace	$10	19%
Kaiser	$10 - $224	19%
Mutual Of Omaha	$10	19%
Rocky Mountain Health	$10	19%
Rocky Mountain Health Plan	$10	19%
Total Longterm Care	$10	19%
Triwest Health Alliance	$10	19%
United	$10 - $284	19%
Wellcare	$10	19%
Pinnacol Workers Comp	$83	156%
Multiplan	$87 - $567	163%
Vail Health	$96	180%
Colorado Program For Children With Special Needs	$214	402%
Life Source Services	$350	657%
Western Plains Community Health	$410	770%
Northcare	$441	828%
Physician Health Partners	$441	828%
Medical Development International	$504	947%
Prime Health	$567	1065%

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 $630.
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 HCA Healthone Mountain Ridge 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.