CMS Price Transparency Data

Blood antibody screen

Facility: Sanford Wheaton Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $103
Cash Discount Price: $94
vs. Medicare Baseline: 1.93x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Sanford Wheaton Medical Center is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.93x the Medicare baseline. Located in 401 12Th Street North, Wheaton, MN.

Cash / Self-Pay

$94

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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: $94 (177%)

Insurance Median: $103 (193%)

Cash: $94 (177% of Medicare)

Ins. Median: $103 (193% 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	$29 - $109	54%
Sanford Health Plan Align	$59	111%
Aetna	$64 - $103	120%
Health Partners	$64 - $96	120%
Medicare (plans)	$64	120%
Ucare	$64 - $104	120%
UnitedHealthcare	$64 - $99	120%
Security Health Plan	$65	122%
Primewest	$66 - $71	124%
Sanford Health Plan	$93 - $110	175%
Medica	$104 - $112	195%
First Choice Health Network	$106	199%
Healthez	$106	199%
Multiplan	$106	199%

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 $94.
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 Sanford Wheaton Medical Center 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.