CMS Price Transparency Data

Blood antibody screen

Facility: St Marys Good Samaritan Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $32
Cash Discount Price: $77
vs. Medicare Baseline: 0.60x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at St Marys Good Samaritan Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.60x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $77 (145%)

Insurance Median: $32 (60%)

Cash: $77 (145% of Medicare)

Ins. Median: $32 (60% 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
Amerigroup	$15	28%
Blue Cross Blue Shield	$23 - $85	43%
Aetna	$32 - $94	60%
Ambetter / Centene	$32	60%
Care Improvement Plus	$32	60%
Caresource	$32	60%
Cigna	$32 - $97	60%
Coventry	$32 - $88	60%
Eon Health Plan	$32	60%
Humana	$32 - $88	60%
Kaiser Permanente	$32	60%
Molina	$32	60%
Pruitthealth Premier	$32	60%
Todays Options Pffs	$32	60%
Todays Options Ppo	$32	60%
UnitedHealthcare	$32 - $2,632	60%
Vaccn United	$32	60%
Wellcare	$32	60%
First Health	$88	165%
Phcs	$88	165%
Meritain	$94	177%
Multiplan	$100 - $103	188%
Nova	$100 - $106	188%
Three Rivers Provider Network	$106	199%

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 $77.
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 St Marys Good Samaritan Hospital 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.