CMS Price Transparency Data

Blood antibody screen

Facility: Maple Grove Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $56
Cash Discount Price: $50
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Maple Grove Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.05x the Medicare baseline. Located in 9875 Hospital Drive, Maple Grove, MN.

Cash / Self-Pay

$50

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: $50 (94%)

Insurance Median: $56 (105%)

Cash: $50 (94% 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
Medica [1086]	$7 - $55	13%
Health Partners [1061]	$36 - $100	68%
Medicaid / KanCare	$37	69%
Blue Cross Blue Shield	$42 - $96	79%
Humana	$54	101%
Medicare (plans)	$54	101%
Ucare [1148]	$54 - $99	101%
UnitedHealthcare	$56 - $132	105%
Aetna	$59 - $70	111%
America'S Ppo [1010]	$64 - $68	120%
Phcs [1172]	$70	131%
Multiplan [1176]	$75	141%
Cigna	$100	188%

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 $50.
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 Maple Grove 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.