CMS Price Transparency Data

Blood antibody screen

Facility: St Lukes Regional Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $45
Cash Discount Price: $57
vs. Medicare Baseline: 0.85x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at St Lukes Regional Medical Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.85x the Medicare baseline. Located in 2720 Stone Park Boulevard, Sioux City, IA.

Cash / Self-Pay

$57

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $57 (107%)

Insurance Median: $45 (85%)

Cash: $57 (107% of Medicare)

Ins. Median: $45 (85% 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 - $143	11%
Nebraska Total Care	$8 - $19	15%
Blue Cross Blue Shield	$10 - $53	19%
Wellmark Uph Self-Funded	$10	19%
Cigna	$13 - $45	24%
Health Partners Open Network	$14 - $80	26%
Aetna	$25 - $131	47%
Medica Exchange Inspire	$37	69%
Medica Exchange Insure	$41	77%
Avera Health Plan	$46	86%
Amerigroup	$47	88%
Iowa Total Care	$47	88%
Molina	$53	100%
Amerivantage	$55	103%
Humana	$55	103%

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 $57.
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 Lukes Regional 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.