CMS Price Transparency Data

Blood antibody screen

Facility: Northwest Health - Porter

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $93
  • Cash Discount Price: $81
  • vs. Medicare Baseline: 1.75x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Northwest Health - Porter is $93. 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 1.75x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$81

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $93 (175%)
Cash: $81 (152% of Medicare)
Ins. Median: $93 (175% 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
Blue Cross Blue Shield $4 - $225 8%
Caresource $10 19%
Humana $10 - $54 19%
Managed Health Services $10 - $110 19%
Medicaid / KanCare $10 19%
Mhs $10 19%
UnitedHealthcare $10 - $55 19%
Veterans Eval Services $10 19%
Tricare $52 98%
Aetna $54 - $131 101%
Medicare (plans) $54 - $58 101%
Node Mhs Mcr Adv $54 101%
Healthy Indiana Plan $55 103%
Node Devoted Health Mcr Adv $55 103%
Node Hospice Non Par Agree $55 103%
Node Va $55 103%
Care Improvement Plus $57 107%
In Dept Of Correction $57 107%
Lutheran Preferred Chs Employees $62 116%
Node Us Dept Of Labor $69 130%
Self Pay $70 - $93 131%
Cigna $72 135%
Align Network $88 165%
One Call Work Comp $88 165%
Encore Health $99 - $206 186%
Physicians Health Plan $99 186%
Prime Health $99 - $194 186%
Php Freedom $107 201%
Indiana Work Comp $110 207%
Lutheran Preferred $110 - $155 207%
Sagamore Health Network $114 - $153 214%
First Health Coventry $126 237%
Encore Ppo $129 242%
Node Encore Kba Epo $132 248%
Porter County $132 248%
Preferred Network Access $132 248%
Magnacare Ma $140 263%
Southeastem Indiana Health Operations $181 - $194 340%
Network Synergy Group $194 364%
Multiplan/Phcs $217 408%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals