CMS Price Transparency Data

Blood antibody screen

Facility: Good Samaritan Medical Center LLC

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $76
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Good Samaritan Medical Center LLC is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.43x the Medicare baseline. Located in 200 Exempla Cir, Lafayette, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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%)

Insurance Median: $76 (143%)

Ins. Median: $76 (143% 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	$6 - $180	11%
Geha	$10 - $104	19%
UnitedHealthcare	$10 - $104	19%
Blue Cross Blue Shield	$17 - $151	32%
Kaiser Perm Hmo	$32 - $76	60%
Kaiser Self Funded	$39 - $76	73%
Kaiser Perm Ppo/Pos	$40 - $78	75%
Allegiance	$43 - $45	81%
Aarp	$53	100%
Kaiser Snp	$54	101%
Select Health	$54	101%
Aetna	$64 - $161	120%
Preferred One	$68 - $72	128%
Humana	$72 - $76	135%
Cofinity	$123 - $130	231%
First Health Network	$123 - $130	231%
Private Hlthcare Sys	$128 - $135	240%
Denv Hlth Med Plan	$140	263%
Multiplan Inc	$145 - $153	272%

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 $X.
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 Good Samaritan Medical Center LLC 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.