CMS Price Transparency Data

Blood antibody screen

Facility: Dukes Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $28
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 0.53x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Dukes Memorial Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.53x the Medicare baseline. Located in 275 W 12Th St, Peru, IN.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $46 (86%)
Insurance Median: $28 (53%)
Cash: $46 (86% of Medicare)
Ins. Median: $28 (53% 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%
Department Of Veterans Affairs $7 - $26 13%
Tricare $7 - $26 13%
Aetna $8 - $66 15%
Humana $8 - $27 15%
In Dept Of Correction $8 - $29 15%
Iu Health Plan $8 - $27 15%
Managed Health Services $8 - $55 15%
Medicare (plans) $8 - $27 15%
Miami County Sheriffs Department $8 - $29 15%
Node Devoted Health Mcr Adv $8 - $28 15%
Node Pphp Mcr Adv $8 - $29 15%
Node Va $8 - $67 15%
UnitedHealthcare $8 - $68 15%
Caresource $9 - $10 17%
Medicaid / KanCare $10 19%
Mhs $10 19%
Veterans Eval Services $10 19%
Lutheran Advanced Network $12 - $41 23%
Lutheran Three Rivers Preferred Plus 150 $12 - $41 23%
Node Lutheran Preferred Fixed 2 $12 - $41 23%
Us Department Of Labor $12 23%
Align Network $13 - $44 24%
Lutheran Preferred $13 - $110 24%
Encore Work Comp In $14 - $50 26%
Lutheran Three Rivers Preferred Plus 175 $14 - $48 26%
Prime Health Services $14 - $104 26%
Partners Direct Health Llc $15 - $52 28%
Lutheran Northwest Health Preferred $16 - $55 30%
Physicians Health Plan $16 - $64 30%
Three Rivers Preferred Plus $16 - $55 30%
Work Comp $16 - $55 30%
Cigna $17 - $138 32%
Php Freedom $18 - $64 34%
Three Rivers Preferred $18 - $62 34%
Encore Kba Epo $19 - $66 36%
Amish Aid $20 - $69 38%
Encore Ppo $20 - $69 38%
Self Pay $20 - $76 38%
Sagamore Health Network $22 - $76 41%
Encore Kba Ppo $24 - $83 45%
Consumer Life $25 - $86 47%
First Health $32 - $110 60%
Multiplan $32 - $112 60%
Advantage Health Solutions $33 - $115 62%
Encore Health Network $33 - $113 62%
Encore $36 - $124 68%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 275 W 12Th St, Peru, IN 46970
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals