CMS Price Transparency Data

Blood antibody screen

Facility: North Adams Regional Hospital Corporation

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $50
  • Cash Discount Price: $80
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at North Adams Regional Hospital Corporation is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.94x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$80

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $80 (150%)
Insurance Median: $50 (94%)
Cash: $80 (150% of Medicare)
Ins. Median: $50 (94% 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
Mcd Masshealth $9 17%
Mcd New York $9 17%
Mcd Out Of State $9 17%
Mcdmanaged Bmchnp $9 - $10 17%
Mcdmanaged Cdphp $9 17%
Mcdmanaged Hne Mcdaco $9 17%
Mcdmanaged Network $9 - $48 17%
Medicaid / KanCare $9 - $37 17%
Comm Hospice $10 - $19 19%
Comm Unicare $10 - $55 19%
Mcr Miscellaneous $10 - $19 19%
Mcrmanaged Usa Family $10 - $19 19%
Mcrmanaged Va $10 - $19 19%
Medicare (plans) $10 - $20 19%
Oth United Vaccn $10 - $19 19%
Blue Cross Blue Shield $11 - $72 21%
Mcrmanaged Cca One Care $11 - $19 21%
Aetna $12 - $64 23%
Comm Fallon Qhp $15 - $48 28%
Tricare $16 - $32 30%
Comm Network Qhpsub $48 - $51 90%
Wc Workers Comp $51 96%
Comm Network Qhpnonsub $54 - $61 101%
Comm Nhp $55 103%
Comm Hne Hmo $56 - $63 105%
Comm Hne $57 - $59 107%
Comm Hne Ppo $59 - $63 111%
Comm Tufts $67 126%
UnitedHealthcare $73 137%
Cigna $76 - $79 143%
Comm Cdphp $76 143%
Comm Mvp $76 143%
Comm Oxford $76 143%
Comm First Health $79 - $80 148%
Comm Connecticare $80 150%
Comm Consolidated Health $80 150%
Comm Harvard $80 150%
Comm Other $80 150%
Comm Phcs $80 150%
Comm Self Pay $80 150%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals