CMS Price Transparency Data

Blood antibody screen

Facility: M Health Fairview Southdale Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $56
Cash Discount Price: $51
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at M Health Fairview Southdale Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.05x the Medicare baseline. Located in 6401 France Avenue South, Edina, MN.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $51 (96%)

Insurance Median: $56 (105%)

Cash: $51 (96% of Medicare)

Ins. Median: $56 (105% 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	$10 - $55	19%
Health Partners	$10 - $120	19%
Itasca Medical Care	$10 - $53	19%
Medica	$10 - $56	19%
Primewest	$10 - $53	19%
South Country Health Alliance	$10 - $53	19%
Ucare	$10 - $122	19%
Hennepin Health	$11	21%
UnitedHealthcare	$17 - $53	32%
Sanford Health Plan	$53 - $78	100%
Security Health Plan	$53 - $100	100%
Wellcare	$53	100%
America'S Ppo	$67 - $96	126%
First Health	$105 - $109	197%
Multiplan	$109 - $113	205%
Private Healthcare Systems	$109 - $113	205%
Wisconsin Physician Services	$115 - $120	216%

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 $51.
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 M Health Fairview Southdale 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.