CMS Price Transparency Data

Blood antibody screen

Facility: Ochsner St Martin Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $13
Cash Discount Price: $18
vs. Medicare Baseline: 0.24x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Ochsner St Martin Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.24x the Medicare baseline. Located in 210 Champagne Boulevard, Breaux Bridge, LA.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

$13

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: $18 (34%)

Insurance Median: $13 (24%)

Cash: $18 (34% of Medicare)

Ins. Median: $13 (24% 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
Aetna	$5 - $94	9%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$5	9%
Healthy Blue (Healthy Louisiana)	$5	9%
Humana	$5 - $23	9%
Louisiana Healthcare Connections (Healthy Louisiana)	$5	9%
UnitedHealthcare	$5 - $23	9%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$7 - $23	13%
Blue Cross Blue Shield	$7 - $25	13%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$7 - $23	13%
Medicare (plans)	$7 - $23	13%
Ochsner Health Plan	$7 - $23	13%
Wellcare Of Louisiana	$7 - $23	13%
Tricare	$8 - $26	15%
Verity Commercial And First Choice Network	$10 - $36	19%
Zelis	$21 - $72	39%
Cigna	$26 - $88	49%

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 $18.
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 Ochsner St Martin 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.