CMS Price Transparency Data

Blood antibody screen

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $66
Cash Discount Price: $134
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at UMass Memorial Health - Harrington Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.24x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

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: $134 (252%)

Insurance Median: $66 (124%)

Cash: $134 (252% of Medicare)

Ins. Median: $66 (124% 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
Medicaid / KanCare	$4 - $9	8%
Masshealth [20302]	$9	17%
Cigna	$13 - $95	24%
Aetna	$22 - $134	41%
Institution [10406]	$62 - $63	116%
Mgb Mcr [10124]	$62 - $63	116%
Champva [11001]	$63	118%
Tufts Us Family [11203]	$63	118%
Blue Cross Blue Shield	$65 - $94	122%
Workers Compensation [20501]	$65	122%
Commonwealth Care Alliance [10103]	$66	124%
Fallon Mcr Supp [20202]	$66	124%
Fallon Mcr [10105]	$66	124%
Tufts Mcr [10112]	$66	124%
UnitedHealthcare	$66 - $134	124%
Senior Whole Health [10110]	$68	128%
Hne [11108]	$87	163%
Tufts [11201]	$95	178%
Fallon Connectorcare [10503]	$96	180%
Wellpoint [11112]	$99	186%
First Health Network [11120]	$100	188%
Tufts Connectorcare [10507]	$106 - $108	199%
Evernorth Behavioral Health [27]	$107	201%
Harvard Pilgrim [10701]	$130 - $157	244%
Connecticare [11105]	$134	252%
Fallon Carelon Hlth [28]	$134	252%
Fallon Mcaid Carelon Hlth [29]	$134	252%
Grants [20507]	$134	252%
Masshealth Mcd Mbhp [38]	$134	252%
Wellsense Mcaid Carelon Hlth [21]	$134	252%
Hsno/Free Care [10801]	$681	1279%

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 $134.
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 UMass Memorial Health - Harrington 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.