CMS Price Transparency Data

Blood antibody screen

Facility: Essentia Health St Mary's Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $102
  • Cash Discount Price: $132
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Essentia Health St Mary's Medical Center is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.92x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$132

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: $132 (248%)
Insurance Median: $102 (192%)
Cash: $132 (248% 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.

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
Medica Access $44 - $89 83%
Primewest $52 98%
Healthpartners Care Pmap $53 - $107 100%
Itasca Med Care $53 100%
Advocare/Security Health $54 101%
Blue Cross Blue Shield $54 - $204 101%
Freedom Blue Ppo $54 101%
Healthpartners Care Msho / Mcr Adv $54 101%
Imcare Msho (Ref Req) $54 101%
Imcare Msho Pcc Prime $54 101%
Imcare Msho Ref Req $54 101%
Medica Advantage Solutions $54 101%
Medica Msho/Dual Solutions $54 101%
Medica Prime Solution Group $54 101%
Medicare (plans) $54 101%
Nd Va Administration $54 101%
Platinum Blue / Vantage Blue $54 101%
Primewest Msho $54 101%
Secure Blue Msho $54 101%
Ubh Cost Plan $54 101%
Ubh Msho $54 101%
Ucare Msho $54 101%
UnitedHealthcare $54 - $196 101%
Sanford Health Plan $57 - $121 107%
Blue Plus Pmap Pcc Prime $58 - $134 109%
Medica $73 - $152 137%
Medica Uplan $73 - $148 137%
Healthpartners $79 - $192 148%
Medica Choice $81 - $164 152%
Ucare $87 - $176 163%
Cigna $94 - $192 177%
Healthpartners Pcc Prime $94 - $192 177%
Wea $95 - $206 178%
America'S Ppo $102 - $208 192%
Security Health $102 - $206 192%
Wps $110 - $225 207%
Aetna $112 - $228 210%
Healthscope Benefits $112 - $228 210%
Healtheos $114 - $230 214%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals