CMS Price Transparency Data

Blood antibody screen

Facility: Shenandoah Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $28
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 0.53x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Shenandoah Medical Center is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.53x the Medicare baseline. Located in 300 Pershing Avenue, Shenandoah, IA.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $44 (83%)
Insurance Median: $28 (53%)
Cash: $44 (83% of Medicare)
Ins. Median: $28 (53% 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.

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
Blue Cross Blue Shield $6 11%
Aetna $16 - $83 30%
Amerigroup Mcaid-All Plans $16 - $29 30%
Home State Health Plan Mcaid-All Plans $16 - $28 30%
Iowa Total Care Mcaid-All Plans $16 - $29 30%
Molina Mcd $16 - $28 30%
Molina Mcr - All Other Plans $16 - $29 30%
Nebraska Total Care Mcaid-All Plans $16 - $28 30%
Tricare $16 - $29 30%
Triwest Wellmark - All Plans $16 - $29 30%
UnitedHealthcare $16 - $84 30%
Wellcare Mcr Adv - All Plans $16 - $29 30%
Midlands Choice-All Plans $45 - $80 85%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Pershing Avenue, Shenandoah, IA 51601
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals