CMS Price Transparency Data

Blood antibody screen

Facility: Decatur County Memorial Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $62
Cash Discount Price: $112
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Decatur County Memorial Hospital is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.16x the Medicare baseline. Located in 720 North Lincoln Street, Greensburg, IN.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$62

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: $112 (210%)

Insurance Median: $62 (116%)

Cash: $112 (210% of Medicare)

Ins. Median: $62 (116% 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
Blue Cross Blue Shield	$10 - $97	19%
Medicaid / KanCare	$10	19%
Encircle-All Plans	$15	28%
UnitedHealthcare	$15 - $43	28%
Choice Care Mcr Adv	$43	81%
Siho Mcr Adv	$43	81%
Caresource Mcr Adv	$45	85%
Aetna	$51 - $113	96%
Caresource Just4Me-All Other Plans	$73	137%
Cigna	$115	216%
Sagamore Health-All Plans	$119	224%
Healthsource Indiana-All Plans	$134	252%
Choicecare Commercial-All Other Plans	$139	261%
Thcg/Encore-All Plans	$140	263%
Siho-All Other Plans	$145	272%

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 $112.
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 Decatur County 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.