CMS Price Transparency Data

Blood antibody screen

Facility: The Orthopaedic Hospital of Lutheran Health Networ

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $55
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at The Orthopaedic Hospital of Lutheran Health Networ is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.03x the Medicare baseline. Located in 7952 W Jefferson Blvd, Ft Wayne, IN.
Cash / Self-Pay
$40

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: $40 (75%)
Insurance Median: $55 (103%)
Cash: $40 (75% 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
Blue Cross Blue Shield $4 - $227 8%
Medicaid / KanCare $9 - $10 17%
Caresource $10 19%
Humana $10 - $54 19%
Managed Health Services $10 - $110 19%
Mhs $10 19%
One Call Work Comp $10 19%
Physicians Health Plan $10 - $100 19%
UnitedHealthcare $10 - $127 19%
Amish Aid $11 - $70 21%
Self Pay $11 - $70 21%
Lutheran Preferred $12 - $155 23%
Php Freedom Network $13 - $18 24%
Cigna $14 - $258 26%
Aetna $16 - $125 30%
Three Rivers Preferred $16 - $116 30%
Sagamore $19 - $140 36%
Encore Ppo $20 - $129 38%
Multiplan $28 - $201 53%
Prime Health Services $30 - $194 56%
First Health $31 - $199 58%
Encore $32 - $206 60%
Tricare $52 98%
Iu Health Plan $54 101%
Medicare (plans) $54 101%
Node Mhs Mcr Adv $54 101%
Small Business Aid $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%
Police And Sheriff $56 105%
In Dept Of Correction $57 107%
Node Pphp Mcr Adv $58 109%
Node Us Dept Of Labor $69 130%
Lutheran Advanced Network $83 156%
Node Lutheran Three Rivers Preferred Plus 150 $83 156%
Occunet In Work Comp $83 156%
Align Network $88 165%
Node Lutheran Three Rivers Preferred Plus 175 $96 180%
Encore Wc $99 186%
Medrisk In Work Comp $99 186%
Three Rivers Preferred In Work Comp $99 186%
Objective Surgical $108 203%
In Work Comp $110 207%
Lutheran Network $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: 7952 W Jefferson Blvd, Ft Wayne, IN 46804
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals