CMS Price Transparency Data

Blood antibody screen

Facility: East Morgan County Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $90
  • Cash Discount Price: $99
  • vs. Medicare Baseline: 1.69x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at East Morgan County Hospital is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.69x the Medicare baseline. Located in 2400 W Edison St, Brush, CO.
Cash / Self-Pay
$99

Average discount available for prompt cash payment at this facility.

Insurance Median
$90

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: $99 (186%)
Insurance Median: $90 (169%)
Cash: $99 (186% of Medicare)
Ins. Median: $90 (169% 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.

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
Aetna $46 - $109 86%
Banner Health $46 - $50 86%
Blue Cross Blue Shield $46 - $88 86%
Clear Spring Health $46 - $50 86%
Healthspring Life & Health Insurance Company, Inc. $46 - $50 86%
Medica $46 - $97 86%
Medicare (plans) $46 - $50 86%
Pinnacol Assurance Workers Comp $46 - $49 86%
Triwest Healthcare Alliance Corp - Va Ccn $46 - $50 86%
UnitedHealthcare $46 - $109 86%
Longevity $48 - $52 90%
Humana $49 - $53 92%
Devoted Health Services $51 - $55 96%
Assist Health Group $56 - $60 105%
Denver Health Medical Plan $86 - $94 162%
Apostrophe, Inc. $97 - $105 182%
First Choice Health Network $97 - $105 182%
Hue Health, Inc $103 - $111 193%
Rocky Mountain Health Plans $103 - $111 193%
Multiplan $105 - $113 197%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 W Edison St, Brush, CO 80723
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals