CMS Price Transparency Data

Blood antibody screen

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $158
Cash Discount Price: $156
vs. Medicare Baseline: 2.97x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at University of Iowa Health Care Medical Center Down is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.97x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$156

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

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: $156 (293%)

Insurance Median: $158 (297%)

Cash: $156 (293% of Medicare)

Ins. Median: $158 (297% 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 297% of the Medicare baseline (a markup of 197%). 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
Aetna	$10 - $337	19%
Blue Cross Blue Shield	$10 - $270	19%
Healthpartners	$10 - $478	19%
Iowa Total Care	$10 - $225	19%
UnitedHealthcare	$10 - $238	19%
Wellpoint (Amerigroup)	$10	19%
Immergrun	$46 - $140	86%
Molina Healthcare	$74 - $225	139%
Medical Associates	$93 - $382	175%
Quad City Community Healthcare	$93 - $422	175%
Midlands Choice	$98 - $365	184%
Oscar Health	$117 - $354	220%
Great River Health Systems	$121 - $393	227%
Aplos Health Plan	$149 - $450	280%
Sedgwick	$149 - $450	280%
Global Excel	$158 - $478	297%
Sanford Health Plan	$158 - $478	297%
Sisco	$164 - $495	308%
Employee Benefit Systems	$167 - $506	314%
Healthsmart	$167 - $506	314%
Hfn	$171 - $517	321%
Multiplan	$171 - $517	321%

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 $156.
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 University of Iowa Health Care Medical Center Down 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.