CMS Price Transparency Data

Blood antibody screen

Facility: Community Hospital of Staunton

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $101
Cash Discount Price: $68
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Community Hospital of Staunton is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.90x the Medicare baseline. Located in 400 N Caldwell St, Staunton, IL.

Cash / Self-Pay

$68

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $68 (128%)

Insurance Median: $101 (190%)

Cash: $68 (128% of Medicare)

Ins. Median: $101 (190% 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
Medicaid / KanCare	$7 - $135	13%
Clear Spring Health Ma	$10 - $41	19%
Medicare (plans)	$10 - $40	19%
Tricare	$13 - $39	24%
Self Pay	$68	128%
Cigna	$87	163%
UnitedHealthcare	$96 - $135	180%
Blue Cross Blue Shield	$101 - $135	190%
Healthlink	$101 - $115	190%
Health Alliance Commercial	$108 - $135	203%
Aetna	$109 - $135	205%
Multiplan/Phcs	$115	216%
Beech Street	$123	231%

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 $68.
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 Community Hospital of Staunton 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.