CMS Price Transparency Data

Blood antibody screen

Facility: Connecticut Childrens Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $88
Cash Discount Price: $99
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Connecticut Childrens Medical Center is $88. 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 1.65x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$99

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $88 (165%)

Cash: $99 (186% of Medicare)

Ins. Median: $88 (165% 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
Aetna	$12 - $139	23%
Golden Rule [100106]	$12 - $139	23%
Harvard Pilgrim [1001134]	$12 - $139	23%
Oxford [100103]	$12 - $139	23%
UnitedHealthcare	$12 - $139	23%
1199 National Benefit Fund [100134]	$13 - $139	24%
Connecticare [100105]	$13 - $88	24%
Emblem Health Commercial [1001108]	$13 - $88	24%
Government Employees Hospital Assoc [100115]	$13 - $139	24%
Humana	$13 - $139	24%
Medicaid / KanCare	$13 - $88	24%
Meritain Health [100149]	$13 - $139	24%
Nippon Life Ins Co Of America [100112]	$13 - $139	24%
Yale Health Plan [100162]	$13 - $139	24%
Blue Cross Blue Shield	$16 - $125	30%
Unicare [100148]	$23 - $125	43%
Wellpoint [100150]	$23 - $125	43%
Cigna	$32 - $143	60%
Great West Healthcare [100107]	$32 - $143	60%
Health Partners [110229]	$32 - $143	60%
Mvp Health Plan [100144]	$32 - $143	60%
Tufts Health Plan [100114]	$32 - $143	60%
Multiplan [1001126]	$120 - $140	225%
Cdphp/Comm [100199]	$140	263%
Generic Multiplan [1001130]	$140	263%
Ultrabenefits/Comm [100181]	$140	263%

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 $99.
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 Connecticut Childrens Medical Center 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.