CMS Price Transparency Data

Blood antibody screen

Facility: Monroe Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $55
  • Cash Discount Price: $54
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Monroe Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.03x the Medicare baseline. Located in 4011 S Monroe Medical Park Blvd, Bloomington, IN.
Cash / Self-Pay
$54

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: $54 (101%)
Insurance Median: $55 (103%)
Cash: $54 (101% 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 $10 - $99 19%
Care Source $10 - $80 19%
Medicaid / KanCare $10 19%
Monroe Medical Group And Managed Health Services $10 - $74 19%
UnitedHealthcare $10 - $55 19%
Aetna $55 103%
Medicare (plans) $55 103%
Tricare $55 103%
Usa Senior Care Network $55 103%
Worthington Christian Fellowship $55 103%
Provider Partners Health Plan $60 113%
Employer Direct Healthcare $77 145%
Corvel Workers Compensation $95 178%
Zelis Healthcare Fka Stratose $104 195%
Americas Choice Provider Network Acpn $106 199%
Multiplan $106 199%
Prime Health Services $106 199%
Three Rivers $106 199%
Encore Health Network Workers Compensation $108 203%
Provider Select $109 205%
Provider Network Of America $110 207%
Workers Compensation $110 207%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4011 S Monroe Medical Park Blvd, Bloomington, IN 47403
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals