CMS Price Transparency Data

Blood antibody screen

Facility: Sterling Regional Medcenter

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $91
Cash Discount Price: $59
vs. Medicare Baseline: 1.71x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Sterling Regional Medcenter is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.71x the Medicare baseline. Located in 615 Fairhurst St, Sterling, CO.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $59 (111%)

Insurance Median: $91 (171%)

Cash: $59 (111% of Medicare)

Ins. Median: $91 (171% 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
Clear Spring Health	$10	19%
Humana	$10	19%
Longevity	$10	19%
UnitedHealthcare	$10 - $111	19%
Devoted Health Services	$11	21%
Pinnacol Assurance Workers Comp	$15 - $57	28%
Aetna	$30 - $109	56%
Banner Health	$33 - $36	62%
Blue Cross Blue Shield	$33 - $93	62%
Healthspring Life & Health Insurance Company, Inc.	$33 - $36	62%
Medica	$33 - $97	62%
Medicare (plans)	$33 - $36	62%
Assist Health Group	$40 - $44	75%
Denver Health Medical Plan	$65 - $71	122%
Apostrophe, Inc.	$97 - $105	182%
First Choice Health Network	$97 - $105	182%
First Choice Of The Midwest	$103 - $111	193%
Hue Health, Inc	$103 - $111	193%
Rocky Mountain Health Plans	$103 - $111	193%
Multiplan	$105 - $113	197%

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 $59.
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 Sterling Regional Medcenter 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.