CMS Price Transparency Data

Blood antibody screen

Facility: Knoxville Hospital & Clinics

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $91
Cash Discount Price: $86
vs. Medicare Baseline: 1.71x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Knoxville Hospital & Clinics is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.71x the Medicare baseline. Located in 1002 South Lincoln Street, Knoxville, IA.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $86 (162%)

Insurance Median: $91 (171%)

Cash: $86 (162% of Medicare)

Ins. Median: $91 (171% 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
Wellmark Hmo 7/1/22	$43	81%
Wellmark Ppo 7/1/22-All Other Plans	$48	90%
Amerigroup Mcaid	$59 - $62	111%
Iowa Total Care Mcaid - All Plans	$59 - $62	111%
Molina Mcaid/Chip - All Plans	$59 - $62	111%
Aetna	$61 - $64	115%
Amerigroup Mcr - All Other Plans	$61 - $64	115%
Humana	$61 - $123	115%
UnitedHealthcare	$61 - $134	115%
Oscar-All Plans	$91 - $96	171%
Health Partners New Bus	$97 - $102	182%
Medical Associates Health Plan-All Other Plans	$104 - $109	195%
Cigna	$134 - $141	252%
Health Partners-All Other Plans	$134 - $141	252%
Medica Op And Profee Only-All Plans	$134 - $141	252%
Midlands Choice-All Plans	$134 - $141	252%

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 $86.
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 Knoxville Hospital & Clinics 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.