CMS Price Transparency Data

Blood antibody screen

Facility: HSHS St Elizabeth's Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $95
  • Cash Discount Price: $81
  • vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at HSHS St Elizabeth's Hospital is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.78x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$81

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $81 (152%)
Insurance Median: $95 (178%)
Cash: $81 (152% of Medicare)
Ins. Median: $95 (178% 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
Meridian Health Plan $3 6%
Molina Healthcare $3 - $58 6%
Amish Community $31 58%
Blue Cross Blue Shield $56 - $112 105%
Clear Spring Health Of Illinois $56 105%
Health Alliance Medical Plans $56 - $95 105%
Health Partners $56 105%
Humana $56 105%
Sae Hospice $56 105%
UnitedHealthcare $56 - $112 105%
Aetna $60 - $79 113%
Wellfirst $72 135%
First Health $83 156%
Cigna $88 - $112 165%
Healthlink $89 - $112 167%
Caterpillar, Inc. $90 169%
Consociate Group $99 186%
Choicecare $101 190%
Healthcare Finest Network (Hfn) $101 190%
Multiplan/Phcs $101 190%
Provider Network Of America $101 190%
Celtic Insurance Company $112 210%
City Of Springfield $112 210%
Claim Doc $112 210%
Current Health Solutions $112 210%
Healthscope $112 210%
Hopetrust $112 210%
Illinois Breast And Cervical Cancer Program $112 210%
Interplan $112 210%
Live360 $112 210%
Wexford $112 210%
Naphcare $125 235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals