CMS Price Transparency Data

Blood antibody screen

Facility: Central Florida Lake Monroe Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $15
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 0.28x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Central Florida Lake Monroe Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.28x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $115 (216%)
Insurance Median: $15 (28%)
Cash: $115 (216% of Medicare)
Ins. Median: $15 (28% 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
Freedom Health $2 - $14 4%
Optimum $2 - $14 4%
Simply $5 - $30 9%
Molina Healthcare $6 - $62 11%
Humana $7 - $39 13%
Avmed $8 - $98 15%
Evolutions $8 - $45 15%
Sunshine State Health Plan $9 - $50 17%
Aetna $10 - $59 19%
Align Senior Care $10 19%
American Health Plan $10 19%
Blue Cross Blue Shield $10 19%
Cigna $10 19%
Devoted Health $10 19%
Fl Health Care Plan $10 19%
Florida Complete Care $10 19%
Ndms Definitive Care $10 19%
Sunshine State $10 19%
United $10 - $88 19%
Wellcare $10 19%
Wellmed $10 19%
Careplus $11 21%
Centurion $11 21%
Clear Spring Health $11 21%
Gold Kidney Of Florida $11 21%
Seminole County Sheriffs Office $11 21%
Ultimate Health Plan $11 21%
Longevity Health Plan $12 23%
Florida Health Care Plan $13 - $74 24%
Oscar $14 26%
Solis Health Plan $14 26%
Simply Healthcare $15 28%
Plotkin Health $17 - $98 32%
Prime Health Sheriff $17 - $98 32%
Multiplan $25 - $166 47%
Three Rivers Provider Network $25 - $146 47%
Ppo Next $29 - $166 54%
Novanet $30 - $176 56%
Corvel Corporation $98 184%
Prime Health $100 188%
Careworks (Rockport Community) $103 193%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals