CMS Price Transparency Data

Blood antibody screen

Facility: Franklin General Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $67
Cash Discount Price: $119
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Franklin General Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.26x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$119

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $119 (224%)

Insurance Median: $67 (126%)

Cash: $119 (224% of Medicare)

Ins. Median: $67 (126% 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	$13 - $111	24%
Medical Associates Mcare	$52 - $54	98%
Mount Carmel Hp-All Plans	$52 - $54	98%
Tricare	$52 - $54	98%
Amerigroup Mcare	$53 - $54	100%
Wellmark Mcr Adv	$53 - $54	100%
Ambetter / Centene	$54 - $86	101%
Molina Mcare	$54 - $56	101%
American Hp Iowa - All Plans	$55 - $56	103%
Amerigroup Mcaid - All Other Plans	$55 - $57	103%
Molina Mcaid - All Other Plans	$55 - $57	103%
Centivo - All Plans	$78 - $80	147%
Medical Ass Hosp Employer Group	$78 - $80	147%
Oscar - All Plans	$78 - $80	147%
Midlands Choice-All Plans	$91 - $94	171%
Wellmark Hmo	$97	182%
Wellmark Ppo - All Other Plans	$107	201%
Medical Associates Hp-All Other Plans	$110 - $114	207%
Preferred Health Choices-All Plans	$110 - $114	207%
Splashlight Llc-All Plans	$110 - $114	207%
Aetna	$121 - $127	227%
Multiplan-All Plans	$124 - $127	233%

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 $119.
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 Franklin General 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.