CMS Price Transparency Data

Blood antibody screen

Facility: South Miami Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $64
  • Cash Discount Price: $97
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at South Miami Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.20x the Medicare baseline. Located in 6200 Sw 73Rd St, Miami, FL.
Cash / Self-Pay
$97

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $97 (182%)
Insurance Median: $64 (120%)
Cash: $97 (182% of Medicare)
Ins. Median: $64 (120% 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
Aetna $2 - $160 4%
Amerigroup $2 4%
Medicaid / KanCare $2 4%
Sunshine State $2 4%
UnitedHealthcare $2 - $200 4%
Vista $2 4%
Wellcare $2 4%
Blue Cross Blue Shield $17 - $130 32%
Avmed $35 - $99 66%
Non Contracted $36 - $73 68%
Cigna $37 - $160 69%
Amerihealth $44 - $90 83%
Medicare (plans) $54 - $73 101%
Medica Health Plan $58 109%
Humana $59 111%
Leon Medical $60 113%
International $64 - $130 120%
Dimension Health Plan $74 - $180 139%
Affordable $83 - $170 156%
Phcs $88 - $180 165%
Quality Health $88 - $180 165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6200 Sw 73Rd St, Miami, FL 33143
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals