CMS Price Transparency Data
Blood antibody screen
Facility: Trinity Health Muskegon Hospital
Billing Code: 86850 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86850
- Insurance Median: $39
- Cash Discount Price: $39
- vs. Medicare Baseline: 0.73x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Trinity Health Muskegon Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.73x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$39
Average discount available for prompt cash payment at this facility.
Insurance Median
$39
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: $39 (73%)
Insurance Median: $39 (73%)
Cash: $39 (73% of Medicare)
Ins. Median: $39 (73% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bcn Domestic | $12 | 23% |
| Blue Benefit Administrators Of Massachusetts | $12 | 23% |
| Blue Care Network | $12 | 23% |
| Blue Cross Blue Shield | $12 - $54 | 23% |
| Blue Distinction Transplant | $12 | 23% |
| Blue Shield - Ca | $12 | 23% |
| Blue Shield - Id (Regence) | $12 | 23% |
| Blue Shield - Ny Highmark Northeastern | $12 | 23% |
| Blue Shield - Ny Highmark Western | $12 | 23% |
| Blue Shield - Pa (Highmark) | $12 | 23% |
| Blue Shield - Wa (Regence) | $12 | 23% |
| Health Choices | $12 - $59 | 23% |
| Kaiser Domestic | $12 | 23% |
| U Of M Health Plan | $12 - $59 | 23% |
| Aetna | $14 - $54 | 26% |
| Geha | $14 - $66 | 26% |
| Meritain | $14 | 26% |
| Acs Benefit Services | $24 - $39 | 45% |
| Allied Benefit Systems | $24 - $39 | 45% |
| Asr Health Benefits | $24 - $40 | 45% |
| Claimchoice Adminstrators | $24 - $39 | 45% |
| Consociate | $24 - $39 | 45% |
| Cypress Benefit Administrators | $24 - $39 | 45% |
| Forest County Potawatomi | $24 - $39 | 45% |
| Hap | $24 - $59 | 45% |
| Health Smart | $24 - $39 | 45% |
| Healthgram | $24 - $39 | 45% |
| Healthscope | $24 - $39 | 45% |
| Preferred One | $24 - $39 | 45% |
| Secureone Preferred United Plans | $24 - $39 | 45% |
| Sisco Benefits | $24 - $39 | 45% |
| The Health Plan | $24 - $39 | 45% |
| Trustmark Small Business Benefits | $24 - $39 | 45% |
| Unified Group Services | $24 - $39 | 45% |
| Webtpa | $24 - $39 | 45% |
| Hospice Of Michigan | $25 - $41 | 47% |
| Wc Accident Fund | $25 - $40 | 47% |
| Wc Advantage | $25 - $40 | 47% |
| Wc Aig | $25 - $40 | 47% |
| Wc Allied | $25 - $40 | 47% |
| Wc Amerisure | $25 - $40 | 47% |
| Wc Amtrust | $25 - $40 | 47% |
| Wc Asu Risk Mgt | $25 - $40 | 47% |
| Wc Berkley Admin | $25 - $40 | 47% |
| Wc Broadspire | $25 - $40 | 47% |
| Wc Bunch & Associates | $25 - $40 | 47% |
| Wc Ccmsi | $25 - $40 | 47% |
| Wc Emc Insurance Company | $25 - $40 | 47% |
| Wc Esis | $25 - $40 | 47% |
| Wc Fcci | $25 - $40 | 47% |
| Wc Federated | $25 - $40 | 47% |
| Wc Gallagher Bassett | $25 - $40 | 47% |
| Wc Genex Care For Ohio | $25 - $40 | 47% |
| Wc Guard Insurance Company | $25 - $40 | 47% |
| Wc Hartford | $25 - $40 | 47% |
| Wc Liberty Mutual | $25 - $40 | 47% |
| Wc Meijers | $25 - $40 | 47% |
| Wc Michigan | $25 - $40 | 47% |
| Wc Mitchell Frankenmuth | $25 - $40 | 47% |
| Wc Pma | $25 - $40 | 47% |
| Wc Sedgwick | $25 - $40 | 47% |
| Wc Sentry | $25 - $40 | 47% |
| Wc Travelers | $25 - $40 | 47% |
| Wc Tristar | $25 - $40 | 47% |
| Wc Walmart | $25 - $40 | 47% |
| Wc Zurich | $25 - $40 | 47% |
| Nomi Health | $26 - $42 | 49% |
| Varipro | $27 - $43 | 51% |
| Caresource | $29 - $47 | 54% |
| Cigna | $29 - $47 | 54% |
| Medicaid / KanCare | $29 - $30 | 54% |
| 1199 National Benefit Fund | $34 - $56 | 64% |
| Allied National Global Care | $34 - $56 | 64% |
| Asrm - Reliance Standard Life Insurance | $34 - $56 | 64% |
| Christian Care Ministry | $34 - $56 | 64% |
| Dean Health | $34 - $56 | 64% |
| Fallon Health | $34 - $56 | 64% |
| Family Life Insurance Company | $34 - $56 | 64% |
| Ghc Scw | $34 - $56 | 64% |
| Group Pension Administrators | $34 - $56 | 64% |
| International Benefit Administrators | $34 - $56 | 64% |
| Lifetime Benefit Solutions | $34 - $56 | 64% |
| Manhattan Life | $34 - $56 | 64% |
| Medi Share | $34 - $56 | 64% |
| Multiplan | $34 - $56 | 64% |
| Mvp | $34 - $56 | 64% |
| Pai | $34 - $56 | 64% |
| Pan-American Life | $34 - $56 | 64% |
| Paramount Hmo | $34 - $56 | 64% |
| Phcs | $34 - $56 | 64% |
| Trinity Health Share | $34 - $56 | 64% |
| Acclaim | $36 - $59 | 68% |
| Administrative Concepts | $36 - $59 | 68% |
| Allegeant | $36 - $59 | 68% |
| Ameriben | $36 - $59 | 68% |
| American Family | $36 - $59 | 68% |
| American Healthcare Alliance | $36 - $59 | 68% |
| American Republic | $36 - $59 | 68% |
| Amerihealth | $36 - $59 | 68% |
| Aultcare | $36 - $59 | 68% |
| Automated Benefit Services | $36 - $59 | 68% |
| Auxiant | $36 - $59 | 68% |
| Benefit Administrative Systems,Llc | $36 - $59 | 68% |
| Boon Chapman | $36 - $59 | 68% |
| Cam Administrative Services | $36 - $59 | 68% |
| Christian Brother Services | $36 - $59 | 68% |
| Christian Brothers Holy Cross | $36 - $59 | 68% |
| Comprehensive Benefits | $36 - $59 | 68% |
| Continental Life Insurance | $36 - $59 | 68% |
| Custom Benefit Administrators | $36 - $59 | 68% |
| Employee Benefit Concepts | $36 - $59 | 68% |
| Employee Benefit Management | $36 - $59 | 68% |
| Enterprise Group Planning | $36 - $59 | 68% |
| Freedom Life Insurance Company | $36 - $59 | 68% |
| Group Administrators | $36 - $59 | 68% |
| Group Marketing Services | $36 - $59 | 68% |
| Guardian | $36 - $59 | 68% |
| Health America | $36 - $59 | 68% |
| Healthez | $36 - $59 | 68% |
| Humana | $36 - $59 | 68% |
| Insight | $36 - $59 | 68% |
| Intercare | $36 - $59 | 68% |
| Jfp Benefit Management | $36 - $59 | 68% |
| Jp Farley Corporation | $36 - $59 | 68% |
| Key Benefit Administrator | $36 - $59 | 68% |
| Liberty Union Life Assurance Co | $36 - $59 | 68% |
| Lucent Health | $36 - $59 | 68% |
| Luminare Health | $36 - $59 | 68% |
| Luminare Health (Detroit) | $36 - $59 | 68% |
| Medben | $36 - $59 | 68% |
| Medcost | $36 - $59 | 68% |
| Medical Mutual | $36 - $59 | 68% |
| Mutual Health Services | $36 - $59 | 68% |
| Mutual Of Omaha | $36 - $59 | 68% |
| Ncas | $36 - $59 | 68% |
| Nippon Life Ins | $36 - $59 | 68% |
| Nova | $36 - $59 | 68% |
| Painters Union Insurance Fund | $36 - $59 | 68% |
| Physicians Mutual | $36 - $59 | 68% |
| Plumbers Local 98 Insurance Fund | $36 - $59 | 68% |
| Prairie States | $36 - $59 | 68% |
| Primary Physician Care | $36 - $59 | 68% |
| Professional Benefit Administrators | $36 - $59 | 68% |
| The Loomis Company | $36 - $59 | 68% |
| Unicare | $36 - $59 | 68% |
| Us Health And Life | $36 - $59 | 68% |
| Valenz | $36 - $59 | 68% |
| Western & Southern Financial Group | $36 - $59 | 68% |
| Wps | $36 - $59 | 68% |
| First Health | $38 - $62 | 71% |
| Access Health | $39 | 73% |
| UnitedHealthcare | $40 - $66 | 75% |
| Barinet | $46 - $75 | 86% |
| Cmh Allegan County | $46 - $75 | 86% |
| Cmh Barry County | $46 - $75 | 86% |
| Cmh Berrien County | $46 - $75 | 86% |
| Cmh Cass County | $46 - $75 | 86% |
| Cmh Kalamazoo | $46 - $75 | 86% |
| Cmh Kent County | $46 - $75 | 86% |
| Cmh Misc | $46 - $75 | 86% |
| Cmh Muskegon County | $46 - $75 | 86% |
| Cmh North Country | $46 - $75 | 86% |
| Cmh Northern Lakes County | $46 - $75 | 86% |
| Cmh Ottawa County | $46 - $75 | 86% |
| Cmh Van Buren County | $46 - $75 | 86% |
| Cmh West Mi County | $46 - $75 | 86% |
| Blue Care Network Advantage | $54 | 101% |
| Medicare (plans) | $54 | 101% |
| Align Senior Care | $56 | 105% |
| Correctional Recovery | $56 | 105% |
| Heartland Hospice | $56 | 105% |
| Hospice Harbor Hospice | $56 | 105% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $63 | 118% |
| Priority Health | $66 - $73 | 124% |
| Oscar | $71 | 133% |
| Molina Marketplace | $72 | 135% |
| Vitalcore | $86 | 162% |
| Wellpath | $86 | 162% |