CMS Price Transparency Data
Blood antibody screen
Facility: Mercy Hospital Joplin
Billing Code: 86850 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86850
- Insurance Median: $28
- Cash Discount Price: $28
- vs. Medicare Baseline: 0.53x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Mercy Hospital Joplin is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.53x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$28
Average discount available for prompt cash payment at this facility.
Insurance Median
$28
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: $28 (53%)
Insurance Median: $28 (53%)
Cash: $28 (53% of Medicare)
Ins. Median: $28 (53% 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 |
|---|---|---|
| Medicaid / KanCare | $5 - $82 | 9% |
| Blue Cross Blue Shield | $8 - $75 | 15% |
| Aetna | $9 - $48 | 17% |
| Humana | $9 - $46 | 17% |
| Medica Contracted [320239] | $9 | 17% |
| Indian Health Service Contracted [320198] | $10 - $28 | 19% |
| United Medical Resources Contracted [320454] | $10 - $28 | 19% |
| UnitedHealthcare | $10 - $68 | 19% |
| Point C Contracted [320238] | $15 - $34 | 28% |
| Ambetter / Centene | $16 | 30% |
| Home State Health Plan Contracted [320187] | $16 | 30% |
| Novasys Contracted [320285] | $16 | 30% |
| Benefit Management Contracted [320052] | $18 | 34% |
| Health Systems Inc Contracted [320174] | $18 | 34% |
| Insurance System Inc Contracted [320465] | $18 | 34% |
| Administrative Payor Contracted [320005] | $19 | 36% |
| Aither Health Contracted [320449] | $20 - $25 | 38% |
| Auxiant Contracted [320462] | $20 - $28 | 38% |
| Ebms Contracted [320493] | $20 | 38% |
| Healthlink Contracted [320179] | $20 - $59 | 38% |
| Imagine 360 Contracted [320494] | $20 | 38% |
| Mercy Benefit Admin Contracted [320251] | $20 - $54 | 38% |
| Reflect Health Contracted [320492] | $20 | 38% |
| Yuzu Health Contracted [320521] | $20 | 38% |
| Cigna | $22 - $48 | 41% |
| Edison Health Solutions Contracted [320502] | $25 | 47% |
| Preferred Health Plan Contracted [320522] | $28 | 53% |
| First Health Contracted [320128] | $29 | 54% |
| American Healthcare Alliance Contracted [320020] | $30 | 56% |
| Multiplan Contracted [320270] | $33 | 62% |
| Private Health Care Systems Contracted [320320] | $33 | 62% |
| Usable Contracted [320409] | $33 | 62% |
| Point C [20238] | $34 | 64% |
| Workers Comp [20426] | $34 - $43 | 64% |
| Usa Managed Care Org Contracted [320429] | $38 | 71% |
| Ppo Plus Contracted [320310] | $39 | 73% |
| Champva [20065] | $48 | 90% |
| Cherokee Nation Health Serv Contracted [320066] | $48 | 90% |
| Cross Timbers Hospice [20098] | $48 | 90% |
| Dept Of Veteran Affairs Contracted [320106] | $48 | 90% |
| Elara Caring Aspire Hospice [20433] | $48 | 90% |
| Globalhealth Contracted [320145] | $48 | 90% |
| Halo Hcr Inc Hospice Contracted [320432] | $48 | 90% |
| Halo Hcr Inc Hospice [20432] | $48 | 90% |
| Kindful Hospice Contracted [320434] | $48 | 90% |
| Kindful Hospice [20434] | $48 | 90% |
| Medicare (plans) | $48 - $50 | 90% |
| Mercy Hospice Okc [20252] | $48 | 90% |
| Mercy Mgd Behavioral Health Contracted [320259] | $48 | 90% |
| Pace Of The Ozarks Contracted [320518] | $48 | 90% |
| Provider Partners Health Plans Contracted [320450] | $48 | 90% |
| Qual Choice Contracted [320325] | $48 | 90% |
| Tricare | $48 | 90% |
| Centivo Contracted [320505] | $49 | 92% |
| 90 Degree Benefits Contracted [320436] | $51 | 96% |
| Show-Me Health Administrators Contracted [320483] | $51 - $54 | 96% |
| Healthscope Contracted [320182] | $61 | 115% |
| Health Choice Contracted [320166] | $91 | 171% |
| Providrs Care Network Contracted [320484] | $99 | 186% |