CMS Price Transparency Data

Blood antibody screen

Facility: The Shriners' Hospital for Children - Boston

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $21
Cash Discount Price: $100
vs. Medicare Baseline: 0.39x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at The Shriners' Hospital for Children - Boston is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.39x the Medicare baseline. Located in 51 Blossom Street, Boston, MA.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

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: $100 (188%)

Insurance Median: $21 (39%)

Cash: $100 (188% of Medicare)

Ins. Median: $21 (39% 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
Ambetter / Centene	$8 - $21	15%
Well Sense Health Plan Nh	$8	15%
Cigna	$9	17%
Providence Health Plan	$14	26%
UnitedHealthcare	$15	28%
Harvard Pilgrim	$18	34%
Amerihealth Caritas Of Nc	$21	39%
Aetna	$62	116%
Health New England	$62	116%
Sana Benefits	$87	163%
Blue Cross Blue Shield	$105	197%
Tufts Network Health Public Plan	$817	1535%

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 $100.
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 The Shriners' Hospital for Children - Boston 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.