CMS Price Transparency Data

Blood antibody screen

Facility: Charlevoix Area Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $102
Cash Discount Price: $109
vs. Medicare Baseline: 1.92x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Charlevoix Area Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.92x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$102

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: $109 (205%)

Insurance Median: $102 (192%)

Cash: $109 (205% of Medicare)

Ins. Median: $102 (192% 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
Blue Cross Blue Shield	$7 - $118	13%
UnitedHealthcare	$9 - $111	17%
Cigna	$10 - $128	19%
Priority Health	$10 - $128	19%
Mclaren Health Plan	$37 - $119	69%
Meridian	$37	69%
Blue Care Network	$60	113%
Hap (Health Alliance Plan)	$60 - $102	113%
Medicare (plans)	$60	113%
Michigan Amish Medical Board	$60	113%
Northern Michigan Mennonite Group	$60	113%
Aetna	$61 - $116	115%
Molina	$65	122%
Provider Network Of America/Hma Group Health	$73 - $109	137%
Hospice Of Michigan	$77	145%
Asr Physicians Care Network	$102	192%
Employee Benefits Logistics	$102	192%
Enterprise Group Planning Employee Benefit Plan	$102	192%
First Health/Coventry Health/Community Care Network	$102	192%
Medical Cost Savings Solution	$102	192%
Three Rivers Provider Network	$109	205%
Iba Health And Life Assurance Company	$118	222%
Cofinity	$119	224%
Nomi Health	$119	224%
Preferred Medical Claim Solutions	$122	229%

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 $109.
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 Charlevoix Area Hospital 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.