CMS Price Transparency Data
Blood antibody screen
Facility: Mercy Hospital Springfield
Billing Code: 86850 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 86850
- Insurance Median: $47
- Cash Discount Price: $158
- vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Mercy Hospital Springfield is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.88x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$158
Average discount available for prompt cash payment at this facility.
Insurance Median
$47
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: $158 (297%)
Insurance Median: $47 (88%)
Cash: $158 (297% of Medicare)
Ins. Median: $47 (88% 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 - $68 | 9% |
| Blue Cross Blue Shield | $7 - $186 | 13% |
| Aetna | $9 - $47 | 17% |
| Humana | $9 - $165 | 17% |
| Medica Contracted [320239] | $9 | 17% |
| Medica [20239] | $9 | 17% |
| United Medical Resources Contracted [320454] | $10 - $126 | 19% |
| UnitedHealthcare | $10 - $187 | 19% |
| Ambetter / Centene | $19 | 36% |
| Home State Health Plan Contracted [320187] | $19 | 36% |
| Novasys Contracted [320285] | $19 | 36% |
| Aither Health Contracted [320449] | $20 - $139 | 38% |
| Auxiant Contracted [320462] | $20 - $158 | 38% |
| Ebms Contracted [320493] | $20 | 38% |
| Healthlink Contracted [320179] | $20 - $59 | 38% |
| Imagine 360 Contracted [320494] | $20 | 38% |
| Mercy Benefit Admin Contracted [320251] | $20 - $139 | 38% |
| Reflect Health Contracted [320492] | $20 | 38% |
| Yuzu Health Contracted [320521] | $20 | 38% |
| Cigna | $22 - $47 | 41% |
| Centurion Of Missouri [20459] | $47 | 88% |
| Champva [20065] | $47 | 88% |
| Cherokee Nation Health Serv Contracted [320066] | $47 | 88% |
| Cross Timbers Hospice [20098] | $47 | 88% |
| Dept Of Veteran Affairs Contracted [320106] | $47 | 88% |
| Elara Caring Aspire Hospice [20433] | $47 | 88% |
| Globalhealth Contracted [320145] | $47 | 88% |
| Halo Hcr Inc Hospice Contracted [320432] | $47 | 88% |
| Halo Hcr Inc Hospice [20432] | $47 | 88% |
| Indian Health Service Contracted [320198] | $47 | 88% |
| Indian Health Service [20198] | $47 | 88% |
| Kindful Hospice Contracted [320434] | $47 | 88% |
| Kindful Hospice [20434] | $47 | 88% |
| Medicare (plans) | $47 - $50 | 88% |
| Mercy Hospice Okc [20252] | $47 | 88% |
| Mercy Mgd Behavioral Health Contracted [320259] | $47 | 88% |
| Mercy Rehab Hospital Contracted [320260] | $47 | 88% |
| Pace Of The Ozarks Contracted [320518] | $47 | 88% |
| Qual Choice Contracted [320325] | $47 | 88% |
| Tricare | $47 | 88% |
| 90 Degree Benefits Contracted [320436] | $51 | 96% |
| Show-Me Health Administrators Contracted [320483] | $51 - $54 | 96% |
| Provider Partners Health Plans Contracted [320450] | $52 | 98% |
| Healthscope Contracted [320182] | $60 | 113% |
| Centivo Contracted [320505] | $80 | 150% |
| Benefit Management Contracted [320052] | $97 | 182% |
| Health Systems Inc Contracted [320174] | $97 | 182% |
| Insurance System Inc Contracted [320465] | $97 | 182% |
| Providrs Care Network Contracted [320484] | $99 | 186% |
| Administrative Payor Contracted [320005] | $109 - $122 | 205% |
| Evolutions Health Care Contracted [320124] | $109 | 205% |
| Point C Contracted [320238] | $109 - $182 | 205% |
| Point C [20238] | $109 | 205% |
| Medical Destinations Contracted [320242] | $122 | 229% |
| Workers Comp [20426] | $122 - $207 | 229% |
| First Health Contracted [320128] | $136 | 255% |
| Edison Health Solutions Contracted [320502] | $139 | 261% |
| Federal Medical Center Contracted [320127] | $146 | 274% |
| Multiplan Contracted [320270] | $187 | 351% |
| Private Health Care Systems Contracted [320320] | $187 | 351% |
| Compcare Of The Ozarks Contracted [320437] | $192 | 361% |
| American Healthcare Alliance Contracted [320020] | $194 | 364% |
| Qual Choice Contracted [320324] | $194 | 364% |
| Municipal Health Plan Contracted [320271] | $197 | 370% |
| Usa Managed Care Org Contracted [320429] | $214 | 402% |
| Ppo Plus Contracted [320310] | $219 | 411% |