CMS Price Transparency Data

Blood antibody screen

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $30
Cash Discount Price: $20
vs. Medicare Baseline: 0.56x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Ascension Providence Hospital, Southfield and Novi is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.56x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

$20

Average discount available for prompt cash payment at this facility.

Insurance Median

$30

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: $20 (38%)

Insurance Median: $30 (56%)

Cash: $20 (38% of Medicare)

Ins. Median: $30 (56% 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
Priority Ppo	$5	9%
Priority Health Hmo	$6	11%
Smarthealth Non Assigned	$6	11%
Bc Metro Detroit Epo	$9 - $10	17%
Bc Metro Detroit Hmo	$9 - $10	17%
Bcn Local Network Southeast	$9 - $1,097	17%
Blue Care Network	$9 - $281	17%
Blue Cross Blue Shield	$9 - $1,097	17%
Aetna	$12 - $52	23%
Hap Alliance Health	$18	34%
Hap Hmo Pos	$18	34%
Hap Preferred	$21	39%
Medicaid / KanCare	$25 - $52	47%
Molina Health	$25 - $30	47%
Blue Caid Michigan	$30	56%
Harbor Health Mcd	$30	56%
Total Health Care	$30	56%
UnitedHealthcare	$30	56%
Amerihealth Vip Care Mcr	$45 - $52	85%
Auto Insurance	$52	98%
Jvhl - Mcr Replacement	$52	98%
Mcr Replacement	$52	98%
Veterans Choice	$52	98%
Humana	$53	100%
Meridian Wellcare	$55	103%
Molina Advantage	$55	103%
Ambetter / Centene	$65	122%
Molina Marketplace	$65	122%
Smart Health	$72	135%

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 $20.
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 Ascension Providence Hospital, Southfield and Novi 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.