CMS Price Transparency Data

Blood antibody screen

Facility: Northside Hospital Duluth

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $91
  • Cash Discount Price: $310
  • vs. Medicare Baseline: 1.71x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Northside Hospital Duluth is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $310. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.71x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
$310

Average discount available for prompt cash payment at this facility.

Insurance Median
$91

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: $310 (582%)
Insurance Median: $91 (171%)
Cash: $310 (582% of Medicare)
Ins. Median: $91 (171% 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
UnitedHealthcare $7 - $73 13%
Us Dept Of Labor Wc $7 13%
Amerigroup $9 - $78 17%
Cigna $9 - $287 17%
Aetna $10 - $91 19%
Institutional Gwinnett County Govt $10 19%
Medicaid / KanCare $10 - $11 19%
Ambetter / Centene $11 - $98 21%
Champus Va $14 26%
Oscar $15 28%
Northside Health Network $17 - $136 32%
Caresource $18 - $169 34%
Georgia Reproductive Specialists $23 - $182 43%
Medlien Healthcare Services $23 - $182 43%
Med Care Solutions $26 - $205 49%
Health One Alliance_Ppo $31 - $250 58%
Quick Trip $31 - $250 58%
Coventry $34 - $309 64%
Kaiser $37 - $396 69%
Blue Cross Blue Shield $40 - $317 75%
Novanet_Ppo $40 - $318 75%
Phcs $43 - $341 81%
Beech Steet $48 - $387 90%
Multiplan $48 - $387 90%
Multiplan Workers Comp $48 - $387 90%
Clear Springs Eon Health $51 96%
Medicare (plans) $51 - $62 96%
Va Ccn $51 96%
Bccp $52 98%
Cbww $52 98%
Humana $52 - $53 98%
Tricare $53 100%
Wellcare $53 100%
Clover Health $54 101%
Pruitt Health Premier $54 101%
Careiq $57 - $455 107%
Dekalb_Department Of Health $57 - $455 107%
Fifa $57 - $455 107%
Institutional Marietta Surgery Center $57 - $455 107%
Institutional Veterans Evaluation Services $57 - $455 107%
Johnson Ferry Imaging $57 - $455 107%
Marietta Dermatology Clinical Research Inc $57 - $455 107%
Rabun County Boc $57 - $455 107%
West Paces Imaging Agreement $57 - $455 107%
Fairly Group $59 111%
Genex/Priority Care Solutions $112 210%
Spreemo $112 210%
Authentic 4D $126 237%
Streamline Imaging $126 237%
Corvel Workers Comp $133 250%
Employers Choice Network $133 250%
Fieldale Farms Wc $140 263%
Georgia Workers Compensation $140 263%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals