CMS Price Transparency Data

Blood antibody screen

Facility: Rush Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $70
Cash Discount Price: $81
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Rush Memorial Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.31x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$70

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: $81 (152%)

Insurance Median: $70 (131%)

Cash: $81 (152% of Medicare)

Ins. Median: $70 (131% 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.

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
Health Net	$16 - $88	30%
Aetna	$17 - $276	32%
Caresource Mcr Adv	$17 - $93	32%
Humana	$17 - $276	32%
My True Advantage - All Plans	$17 - $93	32%
UnitedHealthcare	$17 - $240	32%
Blue Cross Blue Shield	$18 - $219	34%
Today'S Option Mcr Adv-All Plans	$18 - $96	34%
Viant Beech St Mcr Adv	$18 - $96	34%
Caresource Marketplace-All Other Plans	$27 - $149	51%
Cigna	$44 - $240	83%
Phcs-All Plans	$44 - $240	83%
Consumers Life Ins-All Plans	$50 - $270	94%
Coventry/First Health-All Plans	$50 - $270	94%
Multiplan-All Plans	$51 - $279	96%
Sagamore-All Plans	$51 - $276	96%
Siho-All Plans	$51 - $276	96%
Community Health Alliance-All Plans	$52 - $282	98%
Encore Health Services-All Plans	$54 - $294	101%

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 $81.
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 Rush Memorial Hospital 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.