CMS Price Transparency Data

Blood antibody screen

Facility: Atrium Health Navicent the Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $69
Cash Discount Price: $130
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Atrium Health Navicent the Medical Center is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.30x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.

Cash / Self-Pay

$130

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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: $130 (244%)

Insurance Median: $69 (130%)

Cash: $130 (244% of Medicare)

Ins. Median: $69 (130% 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	$6 - $52	11%
Blue Cross Blue Shield	$15 - $52	28%
Cigna	$17 - $76	32%
Aetna	$21 - $181	39%
Kaiser	$24 - $75	45%
Humana	$28 - $178	53%
Alliant	$52 - $62	98%
Georgia Health Advantage	$52	98%
Pruitt Health	$52	98%
Care Source	$53	100%
Clover	$53	100%
Eon Health	$53	100%
Ambetter / Centene	$78 - $132	147%
Securehealth	$91 - $110	171%
Multiplan	$168 - $207	316%
Ibg	$183	344%
Novanet	$207	389%
Three Rivers Provider Network	$220	413%
Beechstreet	$241	453%

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 $130.
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 Atrium Health Navicent the Medical Center 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.