CMS Price Transparency Data

Blood antibody screen

Facility: Northeast Regional Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $125
  • Cash Discount Price: $130
  • vs. Medicare Baseline: 2.35x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Northeast Regional Medical Center is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.35x the Medicare baseline. Located in 315 S Osteopathy, Kirksville, MO.
Cash / Self-Pay
$130

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $130 (244%)
Insurance Median: $125 (235%)
Cash: $130 (244% of Medicare)
Ins. Median: $125 (235% 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 235% of the Medicare baseline (a markup of 135%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Veterans Eval Services $10 19%
Medicaid / KanCare $46 - $74 86%
Node Champva $53 100%
Tricare $53 100%
Medicare (plans) $55 103%
Blue Cross Blue Shield $56 - $100 105%
Node Hospice Non Par Agree $56 105%
Node Va $56 105%
UnitedHealthcare $56 - $247 105%
Node Devoted Health Mcr Adv $58 109%
Blue Pathway/Pathway X $65 122%
Centurion Correctional $70 131%
Us Department Of Labor $70 131%
Self Pay $79 - $181 148%
Home State Exchange $101 190%
Naphcare $106 199%
Cigna $112 - $129 210%
Immergrun $112 210%
Aetna $122 - $274 229%
Blue Prefrerred $135 254%
Blue Access $139 261%
Access Health Services, Llc $214 402%
Healthlink $247 - $263 464%
Multiplan $247 - $263 464%
Coventry Wc $263 494%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 S Osteopathy, Kirksville, MO 63501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals