CMS Price Transparency Data

Blood antibody screen

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $11
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 0.21x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at St Anthony Regional Hospital & Nursing Home is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.21x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $15 (28%)
Insurance Median: $11 (21%)
Cash: $15 (28% of Medicare)
Ins. Median: $11 (21% 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
UnitedHealthcare $1 - $12 2%
Va Ccn - All Plans $1 - $3 2%
Aetna $5 - $14 9%
Humana $5 - $13 9%
Ia Total Care Mcr $5 - $11 9%
Medica Mcr - All Plans $5 9%
Wellpoint Mcr Adv $5 - $10 9%
Ia Total Care Mcaid $6 - $12 11%
Molina Mcaid - All Plans $6 - $12 11%
Wellpoint Mcaid - All Other Plans $6 - $12 11%
Ia Total Care Comm - All Other Plans $7 13%
Midlands Choice - All Plans $13 - $27 24%
Wellmark Hmo $47 88%
Wellmark Ppo-All Other Plans $52 98%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 311 South Clark Street, Carroll, IA 51401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals