CMS Price Transparency Data

Blood antibody screen

Facility: Hammond Henry Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $129
Cash Discount Price: $158
vs. Medicare Baseline: 2.42x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Hammond Henry Hospital is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.42x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$158

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $158 (297%)

Insurance Median: $129 (242%)

Cash: $158 (297% of Medicare)

Ins. Median: $129 (242% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 242% of the Medicare baseline (a markup of 142%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$9 - $131	17%
Blue Cross Blue Shield	$9 - $105	17%
Meridian Health Plan-All Plans	$9	17%
Quad City Community Hc-All Plans	$17	32%
Geneseo Good Samaritan Village Op Only-All Plans	$38	71%
Tricare	$46	86%
Health Alliance Mcare Adv	$51	96%
Humana	$51 - $158	96%
UnitedHealthcare	$51 - $129	96%
Wellmark Of Ia-All Plans	$88	165%
Springfield Armory-All Plans	$114	214%
Ambetter / Centene	$122	229%
Health Alliance-All Other Plans	$131	246%
Multiplan Integrated Hp	$131	246%
Cigna	$135	254%
Multiplan Pponext	$140	263%
Osf Direct Access Network-All Plans	$140	263%
Multiplan-All Other Plans	$149	280%
Corvel-All Plans	$158	297%
Healthsmart Adult-All Other Plans	$158	297%
Healthsmart Pediatric	$158	297%
Hfn-All Plans	$158	297%
Multiplan Beech Street	$158	297%
Multiplan Phcs Adult	$158	297%
Multiplan Phcs Pediatric	$158	297%
Usa Mco-All Plans	$158	297%

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 $158.
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 Hammond Henry Hospital 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.