CMS Price Transparency Data

Blood antibody screen

Facility: HCA Florida Highlands Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $241
  • Cash Discount Price: $1,145
  • vs. Medicare Baseline: 4.53x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at HCA Florida Highlands Hospital is $241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,145. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 4.53x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
$1,145

Average discount available for prompt cash payment at this facility.

Insurance Median
$241

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: $1,145 (2151%)
Insurance Median: $241 (453%)
Cash: $1,145 (2151% of Medicare)
Ins. Median: $241 (453% 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 453% of the Medicare baseline (a markup of 353%). 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
Aetna $10 - $386 19%
American Health Plan $10 19%
Blue Cross Blue Shield $10 19%
Cigna $10 19%
Devoted Health $10 19%
Florida Complete Care $10 19%
Humana $10 - $514 19%
Ndms Definitive Care $10 19%
Prominence Healthfirst $10 19%
Sunshine State $10 - $11 19%
United $10 - $578 19%
Wellmed $10 19%
Centurion $11 21%
Amerihealth Caritas $12 23%
Longevity Health Plan $12 23%
Oscar $19 36%
Simply Healthcare $22 41%
Freedom Health $86 - $111 162%
Prime Health $92 173%
Avmed $131 - $642 246%
Molina $191 - $244 359%
Office Of Sheiff Highland Co $352 - $450 661%
United Ppo $442 - $565 830%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals