CMS Price Transparency Data

Blood antibody screen

Facility: Craig Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $592
  • Cash Discount Price: $328
  • vs. Medicare Baseline: 11.12x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Craig Hospital is $592. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $328. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 11.12x the Medicare baseline. Located in 3425 S Clarkson St, Englewood, CO.
Cash / Self-Pay
$328

Average discount available for prompt cash payment at this facility.

Insurance Median
$592

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: $328 (616%)
Insurance Median: $592 (1112%)
Cash: $328 (616% of Medicare)
Ins. Median: $592 (1112% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1112% of the Medicare baseline (a markup of 1012%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Veterans Administration $45 85%
Cms $53 100%
UnitedHealthcare $53 - $429 100%
Cigna $435 817%
Kaiser $447 840%
Blue Cross Blue Shield $457 858%
Carisk Outcomes $474 890%
Zenith $513 964%
Aetna $537 1009%
Corvel Worker'S Comp $553 1039%
Liberty Mutual Worker'S Comp $553 1039%
Paradigm $553 - $584 1039%
Rocky Mountain Health Plan $576 - $616 1082%
Midwest Employers Casualty $584 1097%
Coventry/First Health $592 1112%
Fcci Worker'S Comp $592 1112%
Geha/Ppo Usa $592 1112%
Great-West Healthcare $592 1112%
Multiplan/Phcs $592 - $624 1112%
Prime Health Services $600 1127%
First Choice Health $616 1157%
Focus Worker'S Comp $632 1187%
General Reinsurance $632 - $671 1187%
Provider Network Of America $632 1187%
Three Rivers Provider Network $632 - $647 1187%
Wyoming Worker'S Comp $632 1187%
Allstate $671 1260%
Tricare $671 1260%
National Provider Network $711 1335%
Up & Up $711 1335%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3425 S Clarkson St, Englewood, CO 80113
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL