CMS Price Transparency Data

Blood antibody screen

Facility: Lincolnhealth

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $133
  • Cash Discount Price: $157
  • vs. Medicare Baseline: 2.50x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Lincolnhealth is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.50x the Medicare baseline. Located in 35 Miles Street, Damariscotta, ME.
Cash / Self-Pay
$157

Average discount available for prompt cash payment at this facility.

Insurance Median
$133

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: $157 (295%)
Insurance Median: $133 (250%)
Cash: $157 (295% of Medicare)
Ins. Median: $133 (250% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 250% of the Medicare baseline (a markup of 150%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $10 - $142 19%
Harvard Pilgrim Healthcare $10 - $147 19%
Humana $11 - $59 21%
Community Health Options $20 - $144 38%
Blue Cross Blue Shield $36 - $320 68%
UnitedHealthcare $59 - $147 111%
Wellcare $62 116%
Cigna $142 267%
Multiplan $147 276%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 35 Miles Street, Damariscotta, ME 04543
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals