CMS Price Transparency Data

Blood antibody screen

Facility: Bluffton Regional Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $25
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 0.47x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Bluffton Regional Medical Center is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.47x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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: $15 (28%)
Insurance Median: $25 (47%)
Cash: $15 (28% of Medicare)
Ins. Median: $25 (47% 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 - $227 8%
Amish Aid $5 - $109 9%
Physicians Health Plan $5 - $110 9%
Self Pay $5 - $250 9%
Cigna $6 - $161 11%
Lutheran Preferred Network $6 - $364 11%
Php $6 - $145 11%
Aetna $7 - $203 13%
Lutheran Trma $8 - $205 15%
Php Management Systems $8 - $176 15%
UnitedHealthcare $9 - $225 17%
Caresource $10 19%
Encore Ppo $10 - $222 19%
Humana $10 - $55 19%
Medicaid / KanCare $10 19%
Mhs $10 19%
Mhs In Hip $10 19%
Sagamore Health Newtork Inc $10 - $244 19%
Sagamore Sebt $10 - $232 19%
Veterans Eval Services $10 19%
Consumer Life $12 - $282 23%
Ahg Dana Employees $13 - $296 24%
Php Freedom Network $13 - $18 24%
Align Networks $14 - $318 26%
Northeast Hospice $14 - $318 26%
Prime Health Services $15 - $341 28%
Private Healthcare Systems Inc $15 - $341 28%
Advantage 360 $16 - $378 30%
Encore Health Network $16 - $410 30%
Multiplan $16 - $364 30%
Community Health Alliance $17 - $387 32%
First Health $17 - $391 32%
Allied Benefit Systems $18 - $410 34%
Cardinal Health Alliance $18 - $410 34%
Ppom $18 - $410 34%
Tricare $52 98%
Medicare (plans) $54 101%
Node Iu Health Mcr Adv $54 101%
Node Mhs Mcr Adv $54 101%
Department Of Veterans Affairs $55 103%
Node Caresource Mcr Adv $55 103%
Node Devoted Health Mcr Adv $55 103%
Node Non Par Hospice Agree $55 103%
Node Va $55 103%
County Jail Health Care $57 107%
In Dept Of Correction $57 107%
Node Pphp Mcr Adv $58 109%
Us Department Of Labor $69 130%
Lutheran Advanced Network $83 156%
Lutheran Three Rivers Preferred Plus 150 $83 156%
Lutheran Three Rivers Preferred Plus 175 $96 180%
Encore Work Comp In $99 186%
Lutheran Northwest Health Preferred $110 207%
Managed Health Services Exchange $110 207%
Workers Compensation $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: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals