CMS Price Transparency Data

Blood antibody screen

Facility: Saint Mary's Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $83
  • Cash Discount Price: $59
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Saint Mary's Hospital is $83. 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 1.56x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$59

Average discount available for prompt cash payment at this facility.

Insurance Median
$83

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: $83 (156%)
Cash: $59 (111% of Medicare)
Ins. Median: $83 (156% 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
Geha $10 19%
Harvard Pilgrim Healthcare $10 19%
UnitedHealthcare $10 - $108 19%
Connecticare $11 21%
Aetna $14 - $61 26%
1199 National Benefit Fund $17 32%
Allied Benefit Systems $17 32%
Gravie Admin Services $17 32%
Hap $17 32%
Luminare Health $17 32%
Meritain $17 32%
Nippon Life Ins $17 32%
Webtpa $17 32%
Allegiance $25 47%
Cigna $25 - $86 47%
Health Partners $25 47%
Magnacare $25 47%
Carelon Behavioral Health $54 101%
Health New England $57 107%
Connecticut Dept of Correction $58 109%
Blue Cross Blue Shield $61 - $185 115%
Medicare (plans) $61 - $64 115%
Cca Senior Care Options $62 116%
Allied National Global Care $83 156%
Asrm - Reliance Standard Life Insurance $83 156%
Christian Care Ministry $83 156%
Dean Health $83 156%
Fallon Health $83 156%
Family Life Insurance Company $83 156%
Ghc Scw $83 156%
International Benefit Administrators $83 156%
Lifetime Benefit Solutions $83 156%
Manhattan Life $83 156%
Medi Share $83 156%
Multiplan $83 156%
Mvp $83 156%
PHCS $83 156%
Pai $83 156%
Pan-American Life $83 156%
Paramount HMO $83 156%
Trinity Health Share $83 156%
Prime Health Services $86 162%
Health Smart $92 173%
United Behavioral Health Eap $108 203%
Centivo $125 235%
Claimdoc $131 246%
Diversified Administrators $131 246%
Innovative Health Plan II $131 246%
Bcn Domestic $185 347%
Blue Benefit Administrators of Massachusetts $185 347%
Blue Care Network $185 347%
Blue Distinction Transplant $185 347%
Blue Shield - Ca $185 347%
Blue Shield - Id (Regence) $185 347%
Blue Shield - Ny Highmark Northeastern $185 347%
Blue Shield - Ny Highmark Western $185 347%
Blue Shield - PA (Highmark) $185 347%
Blue Shield - Wa (Regence) $185 347%
Health Choices $185 347%
Kaiser Domestic $185 347%
Pre-Employment $185 347%
Unicare $185 347%
Wc Domestic $185 347%
Wellpoint $185 347%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals