CMS Price Transparency Data

Blood antibody screen

Facility: Cox Medical Centers

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $34
Cash Discount Price: $31
vs. Medicare Baseline: 0.64x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Cox Medical Centers is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.64x the Medicare baseline. Located in 3801 South National Avenue, Springfield, MO.

Cash / Self-Pay

$31

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $31 (58%)

Insurance Median: $34 (64%)

Cash: $31 (58% of Medicare)

Ins. Median: $34 (64% 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
Coastal Energy Corporation	$16	30%
Heart Of America Beverage Company	$16	30%
Parkcrest Dental Group	$16	30%
Loren Cook	$17	32%
Ozark Anesthesia Assoc. Inc	$17	32%
Springfieldgreene Co Library	$17	32%
Src Holdings Corporation	$17	32%
Blue Cross Blue Shield	$18 - $369	34%
Justice Furniture And Bedding Co	$18	34%
Missouri Affiliated School Consortium (Masc)	$18	34%
Ozark County	$18	34%
Ozarks Cocacola	$18	34%
The Durham Company	$18	34%
Advanced Concrete Technology	$19	36%
Flora Farms	$19	36%
Texas Co Memorial Hospital	$31 - $80	58%
Cox Healthplans	$52	98%
Health Net Federal Services	$52	98%
Humana	$52	98%
Medrisk Llc	$52	98%
UnitedHealthcare	$52 - $135	98%
Allwell	$54	101%
Devoted	$56	105%
Provider Partners Health Plan	$56	105%
Bjc Health Solutions	$86 - $217	162%

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 $31.
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 Cox Medical Centers 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.