CMS Price Transparency Data

Blood antibody screen

Facility: St Joseph Health System, LLC

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $55
  • Cash Discount Price: $34
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at St Joseph Health System, LLC is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.03x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$34

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $34 (64%)
Insurance Median: $55 (103%)
Cash: $34 (64% of Medicare)
Ins. Median: $55 (103% 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
Amish Aid $2 - $54 4%
Php $2 - $91 4%
Self Pay $2 - $125 4%
Cigna $3 - $227 6%
Lutheran Preferred $3 - $136 6%
Aetna $4 - $154 8%
Blue Cross Blue Shield $4 - $227 8%
Lutheran Network $4 - $125 8%
Three Rivers $4 - $102 8%
Encore Ppo $5 - $204 9%
Sagamore $5 - $123 9%
UnitedHealthcare $5 - $113 9%
First Health $7 - $170 13%
Multiplan $7 - $177 13%
Prime Health Services $7 - $170 13%
Advantage Health Solutions $8 - $188 15%
Align Network $8 - $182 15%
Frontpath Health Coalition $8 - $182 15%
Allied Benefit Systems $9 - $204 17%
Caresource $10 19%
Humana $10 - $54 19%
Managed Health Services $10 - $110 19%
Medicaid / KanCare $10 19%
Medical Mutual Of Ohio $10 - $227 19%
Parkview Healthplan Services $10 - $227 19%
Php Freedom Network $10 - $18 19%
Value Options $10 - $227 19%
Veterans Eval Services $10 19%
Tricare $52 98%
Medicare (plans) $54 101%
Department Of Veterans Affairs $55 103%
Node Devoted Health Mcr Adv $55 103%
Node Hospice Non Par Agree $55 103%
Node Va $55 103%
In Dept Of Correction $57 107%
Node Pphp Mcr Adv $58 109%
Us Department Of Labor $69 130%
Lutheran Advanced Network $83 156%
Encore Work Comp In $99 186%
Work Comp $110 207%
Encore Kba Epo $132 248%
Encore Kba Ppo $165 310%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals