CMS Price Transparency Data

Blood antibody screen

Facility: Franciscan Health Michigan City

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $89
Cash Discount Price: $27
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Franciscan Health Michigan City is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.67x the Medicare baseline. Located in 3500 Franciscan Way, Michigan City, IN.

Cash / Self-Pay

$27

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $27 (51%)

Insurance Median: $89 (167%)

Cash: $27 (51% of Medicare)

Ins. Median: $89 (167% 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
Blue Cross Blue Shield	$10 - $190	19%
Mdwise [1175]	$10	19%
Medicaid / KanCare	$10 - $12	19%
Unicare [1150]	$10 - $190	19%
Managed Health Services [1302]	$11	21%
Aetna	$29 - $63	54%
Managed Care [2000]	$29 - $138	54%
Commercial [2001]	$44 - $153	83%
Medicare (plans)	$55	103%
United Medical Resources [1158]	$66 - $92	124%
United Medical Resources [1301]	$66 - $102	124%
UnitedHealthcare	$66 - $102	124%
Cigna	$67 - $107	126%
Great West Insurance [1055]	$67 - $92	126%
Workers Comp [1172]	$110	207%

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 $27.
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 Franciscan Health Michigan City 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.