CMS Price Transparency Data

Blood antibody screen

Facility: Atrium Health Navicent Peach

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $139
Cash Discount Price: $127
vs. Medicare Baseline: 2.61x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Atrium Health Navicent Peach is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.61x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $127 (239%)

Insurance Median: $139 (261%)

Cash: $127 (239% of Medicare)

Ins. Median: $139 (261% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 261% of the Medicare baseline (a markup of 161%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$15 - $53	28%
Aetna	$21 - $149	39%
UnitedHealthcare	$23 - $159	43%
Humana	$28 - $215	53%
Georgia Health Advantage	$53	100%
Pruitt Health	$53	100%
Care Source	$54	101%
Clover	$54	101%
Eon Health	$54	101%
Ambetter / Centene	$76 - $129	143%
Cigna	$76 - $184	143%
Securehealth	$110 - $164	207%
Alliant	$124	233%
Multiplan	$164 - $202	308%
Novanet	$202	379%
Three Rivers Provider Network	$215	404%
Beechstreet	$235	441%

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 $127.
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 Peach 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.