CMS Price Transparency Data

Blood antibody screen

Facility: UW Health

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $79
Cash Discount Price: $37
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at UW Health is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.48x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

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: $37 (69%)

Insurance Median: $79 (148%)

Cash: $37 (69% of Medicare)

Ins. Median: $79 (148% 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
UnitedHealthcare	$14 - $53	26%
Quartz Fully Insured	$50 - $54	94%
Aetna	$53 - $113	100%
Blue Cross Blue Shield	$53 - $77	100%
Humana	$53	100%
Medicare (plans)	$53 - $59	100%
Mychoice Wi Medical Adv	$53	100%
Ecoh	$73 - $123	137%
Hfn	$73 - $123	137%
Alliance Premier Network	$79 - $85	148%
Quartz Aso	$79 - $85	148%
The Alliance	$102 - $110	192%
Wps Ppo	$112 - $121	210%
Cigna	$115 - $125	216%
Beloit Healt System	$130 - $141	244%
Mercycare	$135 - $146	254%
First Health/Coventry	$142 - $154	267%
Health Payment Systems	$169 - $182	317%
Healthsmart	$169 - $182	317%
Sheboygan Employers Health Network	$180 - $194	338%
Multiplan	$201 - $217	378%

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 $37.
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 UW Health 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.