CMS Price Transparency Data

Blood antibody screen

Facility: Nemours Childrens Hospital, Florida

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $86
Cash Discount Price: $170
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Nemours Childrens Hospital, Florida is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.62x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$170

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $170 (319%)

Insurance Median: $86 (162%)

Cash: $170 (319% of Medicare)

Ins. Median: $86 (162% 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
UnitedHealthcare	$9	17%
Cigna	$13 - $98	24%
Avmed	$33 - $75	62%
Employers Health Network Fl	$43 - $97	81%
Florida Blue	$43 - $148	81%
Truli	$43 - $97	81%
Aetna	$47 - $106	88%
Evolutions Healthcare	$48 - $109	90%
Tricare	$54	101%
Integra Administrative Group	$64 - $145	120%
Global Medical Management	$70 - $157	131%
Prime Health Services	$70 - $157	131%
Star Healthcare Network	$70 - $157	131%
Velocity	$80 - $182	150%
First Health Network	$83 - $189	156%
Pnoa	$86 - $194	162%
Seminole Tribe Of Fl	$86 - $194	162%
Private Healthcare Systems	$98 - $223	184%

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 $170.
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 Nemours Childrens Hospital, Florida 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.