CMS Price Transparency Data

Blood antibody screen

Facility: Boston Medical Center-Brighton

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $62
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Boston Medical Center-Brighton is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.16x the Medicare baseline. Located in 736 Cambridge Street, Nevins Building, Brighton, MA.
Cash / Self-Pay
$66

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: $66 (124%)
Insurance Median: $62 (116%)
Cash: $66 (124% 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.

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
Fallon Healthcre Aco [1121] $9 17%
Hlth New England Aco [1123] $9 17%
Mass General Brigham Health Plan Aco [1120] $9 17%
Mass General Brigham Health Plan Mcd Mnged [1107] $9 17%
Medicaid / KanCare $9 17%
Tufts Together Aco [1122] $9 17%
Tufts Together Mco [1125] $9 17%
Wellsense Alli Aco [1118] $9 17%
Wellsense Essential Mco [1101] $9 17%
Aetna $29 - $62 54%
Meritain Health [1023] $29 54%
Blue Cross Blue Shield $62 - $73 116%
Humana $62 116%
Medicare (plans) $62 - $66 116%
Neighborhood Pace [1206] $62 116%
Senior Whole Health [1210] $62 116%
Ubh Hphc [8016] $62 116%
United Community Plan [1202] $62 116%
UnitedHealthcare $62 116%
Veterans Admin [9003] $62 116%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010] $62 116%
Cca [1215] $66 124%
Eternalhealth [1227] $66 124%
Zzzcca Onecare [1216] $66 124%
Fallon [8008] $81 152%
Unicare [8004] $109 205%
Wellpoint [2034] $109 205%
Mass General Brigham Health Plan Commercial [8009] $110 207%
Mass General Brigham Health Plan Prime [7003] $110 207%
Harvard Pilgrim Health Care [8001] $129 242%
Tufts [8002] $162 - $184 304%
Cigna $184 346%
Hsn Bad Debt [4003] $475 892%
Hsn Confidential [4007] $475 892%
Hsn Dental [4006] $475 892%
Hsn Partial [4002] $475 892%
Hsn [4001] $475 892%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 736 Cambridge Street, Nevins Building, Brighton, MA 02135
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals