CMS Price Transparency Data

Blood antibody screen

Facility: Woodlawn Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $35
  • Cash Discount Price: $118
  • vs. Medicare Baseline: 0.66x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Woodlawn Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.66x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.
Cash / Self-Pay
$118

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $118 (222%)
Insurance Median: $35 (66%)
Cash: $118 (222% of Medicare)
Ins. Median: $35 (66% 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 - $119 8%
Mdwise Excel Hhw & Hcc $5 9%
Caresource Mcaid Hww $10 19%
Mhs Mcaid Hcc $10 19%
Mhs Mcaid Hhw $10 19%
UnitedHealthcare $10 - $119 19%
Partners Direct Health-All Plans $15 28%
Aetna $35 - $149 66%
Caresource Mcaid Hip $35 66%
Caresource Mcr Adv $35 66%
Humana $35 - $122 66%
Mdwise Mcaid Excel Hip $35 66%
Mhs Exch Mrktplce-All Other Plans $35 66%
Mhs Mcaid Hip $35 66%
Mhs Mcr Adv $35 66%
Caresource Exch - All Other Plans $45 85%
Ambetter / Centene $46 86%
Cigna $112 - $133 210%
Parkview Health Plans-All Plans $118 222%
Sagamore All Other Grps - All Other Plans $132 248%
Encore Comm-All Plans $133 250%
Phcs/Multiplan-All Plans $146 274%
Community Health Alliance-All Plans $149 280%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 E 9Th St, Rochester, IN 46975
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals