CMS Price Transparency Data

Blood antibody screen

Facility: Buchanan County Health Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $152
Cash Discount Price: $144
vs. Medicare Baseline: 2.85x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Buchanan County Health Center is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $144. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.85x the Medicare baseline. Located in 1600 First St East, Independence, IA.

Cash / Self-Pay

$144

Average discount available for prompt cash payment at this facility.

Insurance Median

$152

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: $144 (270%)

Insurance Median: $152 (285%)

Cash: $144 (270% of Medicare)

Ins. Median: $152 (285% 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 285% of the Medicare baseline (a markup of 185%). 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
Champus	$61 - $169	115%
Health Partners	$61 - $169	115%
Blue Cross Blue Shield	$85 - $169	160%
Cigna	$140	263%
UnitedHealthcare	$151 - $169	284%
Aetna	$152 - $169	285%
Humana	$169	317%
Iowa Total Care	$169	317%
Molina Healthcare	$169	317%
Wellpoint Iowa	$169	317%

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 $144.
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 Buchanan County Health 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.