CMS Price Transparency Data

Blood antibody screen

Facility: Astera Health

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $118
Cash Discount Price: $110
vs. Medicare Baseline: 2.22x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Astera Health is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.22x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$110

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

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: $110 (207%)

Insurance Median: $118 (222%)

Cash: $110 (207% of Medicare)

Ins. Median: $118 (222% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 222% of the Medicare baseline (a markup of 122%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 Plus Pmap [40002]	$30 - $5,128	56%
Ucare Pmap [30006]	$57 - $1,691	107%
Blue Cross Blue Shield	$62 - $5,128	116%
Health Partners [10045]	$62 - $5,128	116%
Medica Nonpmap [10056]	$62 - $12,118	116%
Medica Pmap [10057]	$62 - $3,448	116%
Primewest Non Pmap [30004]	$62 - $5,128	116%
Primewest Pmap [30003]	$62 - $3,448	116%
Ucare Non Pmap [30007]	$65 - $5,385	122%
Health Partners Pmap [10046]	$78	147%
Ucare Commercial [10705]	$108 - $116	203%
UnitedHealthcare	$116 - $120	218%
Multiplan	$124	233%
Sanford Health Plan [10120]	$132	248%
Aetna	$140	263%

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 $110.
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 Astera Health 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.