CMS Price Transparency Data

Blood antibody screen

Facility: Palmetto General Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $53
  • Cash Discount Price: $349
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Palmetto General Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $349. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.00x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$349

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

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: $349 (656%)
Insurance Median: $53 (100%)
Cash: $349 (656% of Medicare)
Ins. Median: $53 (100% 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
Humana $2 - $142 4%
Medicaid / KanCare $2 - $349 4%
UnitedHealthcare $2 - $52 4%
Aetna $6 - $248 11%
Dimension Health Wc $6 11%
Workers Compensation $6 11%
Avmed Broad Network $9 17%
Healthsun Health Plans $10 - $54 19%
Employer Direct Healthcare $12 - $53 23%
Imagine Health $12 23%
Oscar Health Plan Hix $12 23%
Self Pay/Uninsured $12 - $65 23%
Veterans Administration Mill Bill $36 68%
Medicare (plans) $47 - $349 88%
Bc/Bs Myblue Hmo Hix $50 94%
Bc/Bs Of Fl Network Blue $50 94%
Bc/Bs Of Fl Simplyblue $50 94%
Devoted Health $52 98%
Leon Health Inc $52 98%
Tricare $52 98%
Bc/Bs Of Fl Blue Select Exchange Non Par $53 100%
Bc/Bs Of Fl Health Options Hmo $53 100%
Bc/Bs Of Fl Ppo $53 100%
Bristol Hospice- Miami Dade Llc $53 100%
Catholic Hospice $53 100%
Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc $53 100%
Hospice Other $53 100%
Ima Evalutations Inc $53 100%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $53 100%
Opuscare Of South Fl $53 100%
Seasons Hospice And Pallative Care Of Southern Florida Inc $53 100%
Select Specialty Hospital $53 100%
Veterans Administration Vaccn $53 100%
Vitas Healthcare Hospice $53 100%
Westchester General Hospital $53 100%
Cigna $54 - $174 101%
Longevity Health Plan $55 103%
Florida Pace Centers $62 116%
Bright Health Management Commercial $63 118%
Bc/Bs Of Fl Miami Dade Blue Select $70 131%
Naphcare Inc $72 135%
Avmed Exchange $92 173%
Ambetter / Centene $97 182%
Molina Marketplace Program Exchange $100 188%
Auto Insurance $105 197%
Avmed Select Network $108 203%
Amerihealth Caritas Next Exchange $113 212%
Liga Contra El Cancer $174 327%
Bc/Bs Of Fl Phs $175 329%
Magellan Behavioral Health $209 393%
Dimensions International $227 426%
First Health $234 440%
Dimension Health Ppo $262 492%
Beacon Health Strategies Commercial $349 656%
Commercial Non-Contracted $349 656%
Self Pay - Mcd Pending 100 Percent $349 656%
Single Case Agreement $349 656%
United Behavioral Health Psych $349 656%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2001 W 68Th St, Hialeah, FL 33016
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals