CMS Price Transparency Data

Blood antibody screen

Facility: Children's Hospital Colorado

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $154
  • Cash Discount Price: $156
  • vs. Medicare Baseline: 2.89x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Children's Hospital Colorado is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.89x the Medicare baseline. Located in 13123 E 16Th Ave, Aurora, CO.
Cash / Self-Pay
$156

Average discount available for prompt cash payment at this facility.

Insurance Median
$154

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: $156 (293%)
Insurance Median: $154 (289%)
Cash: $156 (293% of Medicare)
Ins. Median: $154 (289% 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 289% of the Medicare baseline (a markup of 189%). 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
Ccha Behavioral Health $5 - $62 9%
Integrated Health Plan $8 - $93 15%
Kaiser $18 - $455 34%
Rocky Mountain Health Plan Behavioral Health $21 - $249 39%
Carelon Behavioral Health $23 - $436 43%
Denver Health Medical Plan $23 - $467 43%
UnitedHealthcare $24 - $311 45%
Colorado Access $25 - $305 47%
Colorado Access Behavioral Health $25 - $305 47%
Presbyterian Health Plan $25 - $355 47%
Blue Cross Blue Shield $27 - $467 51%
Molina Healthcare Of Nebraska $29 - $343 54%
Molina Healthcare Of New Mexico $29 - $343 54%
Peak Health Alliance/Ebms $29 - $374 54%
Rocky Mountain Health Plan $29 - $405 54%
Healthy Blue Of Nebraska $30 - $361 56%
Humana $32 - $436 60%
Evernorth Behavioral Health $34 - $405 64%
Interlink National $34 - $467 64%
Centivo $36 - $430 68%
Select Health $36 - $436 68%
Uchealth Plan Administrators $36 - $436 68%
Aetna $38 - $498 71%
Cigna $38 - $449 71%
Department Of Corrections $41 - $486 77%
Comppsych Behavioral Health $44 - $529 83%
First Choice Health $44 - $529 83%
Midlands Choice $44 - $529 83%
National Preferred Provider Network $44 - $529 83%
Multiplan $45 - $536 85%
Cofinity $47 - $561 88%
First Choice Of The Midwest $47 - $561 88%
Usa Managed Care Organization $47 - $561 88%
First Health Network $48 - $573 90%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13123 E 16Th Ave, Aurora, CO 80045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens