CMS Price Transparency Data

Blood antibody screen

Facility: Witham Health Services

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $162
Cash Discount Price: $173
vs. Medicare Baseline: 3.04x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Witham Health Services is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 3.04x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$173

Average discount available for prompt cash payment at this facility.

Insurance Median

$162

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: $173 (325%)

Insurance Median: $162 (304%)

Cash: $173 (325% of Medicare)

Ins. Median: $162 (304% 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 304% of the Medicare baseline (a markup of 204%). 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	$10 - $236	19%
Blue Cross Blue Shield	$10 - $251	19%
Caresource Indiana Marketplace-All Other Plans	$10	19%
Caresource Mcr Adv	$10	19%
Mdwise Health In-All Plans	$10	19%
UnitedHealthcare	$113 - $207	212%
Phcs/Multiplan-All Plans	$159 - $290	299%
Sagamore-All Plans	$160 - $294	301%
Humana	$162 - $297	304%
Beech Street-All Plans	$164 - $300	308%
Encore-All Plans	$166 - $303	312%
Mhs Comml Exch-All Plans	$436 - $798	819%

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 $173.
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 Witham Health Services 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.