CMS Price Transparency Data

Blood antibody screen

Facility: Norton Scott Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $149
Cash Discount Price: $56
vs. Medicare Baseline: 2.80x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Norton Scott Hospital is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.80x the Medicare baseline. Located in 1451 N Gardner St, Scottsburg, IN.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$149

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: $56 (105%)

Insurance Median: $149 (280%)

Cash: $56 (105% of Medicare)

Ins. Median: $149 (280% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 280% of the Medicare baseline (a markup of 180%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$7 - $188	13%
Caresource Indiana Healthy Indiana Plan (Hip)	$10	19%
Caresource Indiana Hoosier Healthwise (Hhw)	$10	19%
Caresource Indiana Just4Me	$10	19%
Managed Health Services (Mhs)	$10 - $77	19%
Managed Health Services (Mhs) Hoosier Care Connect	$10	19%
Mdwise Hoosier Healthwise (Hhw)	$10	19%
UnitedHealthcare	$10 - $191	19%
Molina Healthcare	$55 - $57	103%
Managed Health Services (Mhs) Healthy Indiana Plan (Hip)	$58 - $77	109%
Mdwise Healthy Indiana Plan (Hip)	$58 - $77	109%
Communicare Advantage	$60 - $79	113%
Aetna	$153 - $202	287%
Multiplan	$194 - $273	364%
Cigna	$207 - $273	389%
Encore Health Network	$207 - $273	389%
Prime Health	$207 - $273	389%
Ppom	$214 - $282	402%
Intercommunity Health Network (Ihn)	$219 - $289	411%

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 $56.
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 Norton Scott 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.